NEW PLAN
THE UNITED STATES FEDERAL GOVERNMENT SHOULD PROVIDE ADDITIONAL FINANCIAL AND TECHNICAL RESOURCES AS NECESSARY TO ENSURE COMPREHENSIVE DISEASE SURVEILLANCE PROGRAM IN AFRICA SOUTH OF THE SAHARA
Contention One is Inherency
Disease surveillance systems in Africa are failing due to a severe lack of funds.
James Thuo Njugana, Master’s Degree in Biotechnology; Writer, Bonn International Center for Conversion, Biological and Chemical Weapons; Member, International Livestock Research Institute, worked on control of trypanosomosis and malaria; Writer, African Security Review [Peer Reviewed], 2005, Institute for Security Studies, African Security Review, Volume 14, Issue 1, http://www.openj-gate.org/Articlelist.asp?Source=1&Journal_ID=103955bchang
Disease surveillance and control Infectious diseases can undermine the security of a country whether these diseases are deliberately inflicted by biological warfare or occur naturally. While the Biological and Toxins Weapons Convention (BTWC) prohibits the development and use of biological weapons, the defence against a natural or intentional epidemic is the same: a robust global public health surveillance system and the ability to respond efficiently and effectively to disease outbreaks. The state has an important role in combating the threat of deliberate disease because it has the moral duty to protect its citizenry. An effective way of countering the threat of deliberate disease is to establish and maintain disease surveillance and control programmes. Most of the publications on epidemics in eastern Africa indicate that very little disease surveillance is done at present.33 Where gains were made in control and eradication, they were later lost through neglect of control protocols such as vaccinations and control of livestock movements between endemic and non-endemic areas. There seems be unanimous agreement among observers that the main reason for the failure of surveillance and control systems is lack of funding. This is blamed on reduced funding for the responsible government organs and agencies owing to shrinking economies. National governments and other interested stakeholders will have to find the required funds, for if infectious diseases are not eradicated or at least maintained at minimum levels, an added threat will be their use as biological weapons, endangering people away from the endemic areas.34 Observers have expressed the view that disease surveillance should be intensified and coordinated beyond the divide of national boundaries. Surveillance programmes should be part of the public health management systems. The ideal situation requires setting up local and international surveillance/response teams. Teams endowed with the necessary techniques and resources should be put in place so that they can deal with epidemics when they occur. This will ensure that expertise in dealing with these diseases is available uniformly throughout the region.35 It is also important to register the groups/individuals engaged in these emergencies to minimise chances of hazardous materials being acquired by groups whose intent would be to cause disease outbreaks. Vaccination programmes have to be maintained because failure to do so may lead to a loss of the gains previously achieved in terms of disease control. Besides, for every case of sickness encountered, prevention is cheaper than cure. Some authors encourage joint veterinary and human disease surveillance as a way of cost cutting for zoonotic disease control and such a team can be schooled to monitor biological weapons as well (see the commentary by Dorothy Preslar in this issue of African Security Review).
Plan: The United States federal government should mandate the supply of all necessary resources to disease surveillance programs in sub-Saharan Africa.
Advantage One—Bioterrorism
Current African public health systems don’t take bioterrorism seriously; revitalizing disease surveillance systems is necessary to solve.
Do African countries share the perception that the threat of the use and development of biological weapons is increasing? Do African countries perceive themselves to be at risk from states or terrorist groups that may use biological weapons? What is the significance of the BTWC for Africa ? What more can be done to ensure that biological weapons are not used or developed on the African continent? What can non-governmental organisations, scientists, academics and government officials do to make Africa more secure? These are some of the questions that contributors to this volume have addressed. Several papers in this issue consider the perception of the relative insignificance of the threat of biological weapons use in Africa. This appears to be reflected in the high number of African states that have either not joined the BTWC, or that have signed but not ratified the convention. The authors of these papers present cogent arguments to support the contention that biological weapons control is an issue that should receive the attention of all African Union members. In his commentary the United Nations Under-Secretary-General for Disarmament Affairs, Nobuyasu Abe, notes that ‘increasing the number of African states parties to the BTWC would bring the convention closer to universality and send a strong message that the issue of biological weapons is truly a global concern and that Africa and the rest of the international community are united in grappling with it’. This view is echoed in the contribution by Dominique Loye and John Borrie, which provides details of the biotechnology, weapons and humanity appeal by the International Red Cross. Loye and Borrie also present a number of reasons that African countries should take the concern about biological weapons seriously. They argue that because African countries often lack sophisticated public health systems, a deliberate outbreak of disease could have catastrophic consequences. In his contribution, Dr Ben Steyn -considers the implications of UN Security Council Resolution 1540 and raises important -questions about how the resolution will be -interpreted and implemented. His article highlights the many difficulties, which are inherent to attempts to control biological agents. Through his analysis it becomes clear that the cost to states of implementing the resolution will be high and he indicates that unless key questions are answered about its implementation, the resolution may ‘create a false sense of security while the threat remains’. In his paper Thuo Njuguna draws attention to the effects that deliberate disease may have on the already overburdened public health system in East Africa and notes that the public health and disease surveillance systems necessary to deal with naturally occurring disease and deliberately caused disease are the same. In other words, strengthening public health systems and the ability to carry out disease surveillance is an important step in defending populations against the effect of deliberately caused disease. Dorothy Preslar’s commentary carries this argument further and assesses the potential benefits (and dangers) of increased transparency in reporting disease outbreaks. In her contribution Angela Woodward considers the type of legislation that states need to adopt to ensure they are in compliance with their obligations under the BTWC and UNSC Resolution 1540 and assesses the status of such legislation in African states. Her assessment reveals that there is still much that can be done in Africa. It is my hope that this publication will serve to initiate and inform increased debate and discussion about how Africans can work towards ensuring that biological weapons are never used or developed on this continent.
We’ll win probability and timeframe—Africa’s political climate means that a bioweapon attack is both imminent and inevitable. Terrorists already have access to weapons; they could attack at any time.
James Thuo Njugana, Master’s Degree in Biotechnology; Writer, Bonn International Center for Conversion, Biological and Chemical Weapons; Member, International Livestock Research Institute, worked on control of trypanosomosis and malaria; Writer, African Security Review [Peer Reviewed], 2005, Institute for Security Studies, African Security Review, Volume 14, Issue 1, http://www.openj-gate.org/Articlelist.asp?Source=1&Journal_ID=103955bchang
Eastern Africa has seen many conflicts since World War II. Freedom wars, inter-state wars, civil wars and ethnic violence are either ongoing or are part of recent history.3 Economic hardship and inequalities, distrust of government and religious extremism are among the factors that have created a climate in which individuals or groups feel that any action they may take, however heinous, is justified in furthering their cause. This contributes to insecurity in the region and the world at large. Terror attacks in recent years, such as the bombing of the Oklahoma government building in the US (1995), the US embassy bombings in Kenya and Tanzania (1998),4 the attacks on the World Trade Center on 11 September 2001, and attacks in Morocco, Indonesia, Russia, Egypt and Spain, have led observers to realise the apparent danger of terrorist threats all over the world. Future terrorist attacks will -continue to involve bombs and firearms, but may also involve the use of biological weapons to cause disease.5 Major infectious diseases known to have potential in biological warfare are endemic in eastern Africa and often cases of emerging disease are reported from the region. This means that the disease-causing micro-organisms occur naturally in the region and are therefore accessible to those with sufficient knowledge to use to deliberately cause disease. This is an adequate reason to presume that eastern Africa, like other regions with similar conditions, faces a potential threat from BW. Outbreaks of Ebola fever (in Uganda and Sudan),6 Rift Valley fever (in Kenya and Somalia)7 and yellow fever (in Kenya)8 have been reported in recent years. The outbreaks of Ebola fever and Rift Valley fever in Uganda and Kenya respectively showed that the region has insufficient resources to deal with such epidemics. A successful deliberate disease attack would probably cripple the public health system. Both lethal and incapacitating agents could have an adverse impact on the civilian health care delivery system in a BW attack scenario. Potential manifestations include terror in the affected population and medical care personnel; an overwhelming number of casualties, placing demands on special medications; a need for personal protection in medical care settings and clinical laboratories; and problems with general handling.9 Biological agents with potential use as biological weapons The biological agents thought most likely to be used as biological weapons include B anthracis (anthrax), Francisella tularensis (tularemia), Yersinia pestis (plague), Variola virus (smallpox), agents of viral haemorrhagic fevers, and botulism toxin. Other likely agents include Brucella spp (brucellosis), Vibrio cholerae (cholera), Burkholderia pseudomallei (glanders), Coxiella burnetti (Q fever), agents of viral encephalitis, staphylococcal enterotoxin, ricin and mycotoxins (table 1).10 More than half of the organisms recognised as having a potential in biological warfare are endemic to the eastern Africa region. Elsewhere, the severe acute respiratory -syndrome (SARS) epidemic is the most recent reminder to the world of the challenges that emerging infectious diseases pose to health care systems, economies and overall security. While infectious diseases have traditionally been regarded as a medical issue, the threats posed by them in a rapidly changing global environment are no longer confined to the sphere of health risks. The disruption of business activities, travel and tourism (and hence economic growth and development) following the outbreak of SARS is among the serious potential repercussions that necessitated defining it and similar epidemics in broader, more strategic terms.11 Today the scale, speed and extent of the movement of people and goods are unprecedented. These movements, in turn, have shaped the appearance, spread and distribution of infectious diseases, not just in humans, but also in animals.12 The SARS case is instructive. With the movement of people in and out of China and the ease of international air travel, it was not surprising that SARS spread to more than 31 countries in every region of the world in less than six months.13 Indeed, in a -globalised world, no community can be entirely immune from emerging infectious diseases.14 While SARS appeared to have been contained, at least temporarily, by the end of 2003 and thus far has not become a global epidemic in the way that HIV/AIDS has,15 the economic losses associated with it may be felt for a long time in many countries. Similar cases of major economic damage and of the way the costs can be aggravated by initial lack of transparency are well documented for other infectious diseases, human and animal, originating in both wealthier and poorer countries.16 The HIV/AIDS pandemic continues and no clearly successful concerted international action exists to deal with it. A wide gap still exists between the threat posed by HIV/AIDS and coordinated, effective international action. Within a few years of its identification, HIV/AIDS had spread to every continent and every country. So far, 25 million people have died of AIDS, and about 3 million people a year continue to die from the disease. This massive loss of human resources involves the most economically productive group of the population, altering the economic and social structures of the countries that are most affected.17 It is widely acknowledged that openness has contributed directly to the relative success of Uganda in tackling AIDS.18 On the one hand, widespread coverage in the media has raised public awareness about the nature of the disease and avoiding infection. On the other hand, the willingness of those working in the health professions to share their knowledge and experience with journalists has encouraged informed reporting that, in turn, has strengthened the ability of individuals to take effective precautionary measures.19 This is in contrast to the approach taken by some governments on the same subject where information on the transmission of the disease (HIV/AIDS) to the public is confused or unclear.20 Unfortunately it follows that information on the control and prevention of the disease becomes unclear in the process. In 2000 the United Nations Security Council declared AIDS an international security threat, followed by similar political endorsements at the meetings in Okinawa and Genoa of the Group of Eight industrialised countries (G8).21 Despite these initiatives, however, AIDS, tuberculosis, malaria and other endemic diseases are perceived by many countries (if not most) as health or social problems, not as human -security threats. The lesson learned from the AIDS outbreak in Africa is that the media can be an important instrument of health policy. Countries whose governments provide the media with contradictory or incorrect information, as has happened with AIDS in some countries in Africa, or that conceal information, as occurred at the beginning of the SARS epidemic, risk losing the war against such diseases. Yet it remains common practice for many governments to consider that access to information by journalists, even in these areas, should be strictly controlled or managed.22 Openness to the media and the public is not simply a question of issuing timely and informative press releases.23 Management and containment of epidemics Ministries of health (MoHs) across Africa are mandated to deal with all health issues -including budgetary allocations to deal with infectious disease outbreaks. They are -responsible for -containing disease outbreaks wherever they occur in a country. Hospitals and care-giving institutions have a core function owing to their being in a special position to recognise an emerging outbreak of a given disease.24 Early detection of a biological agent attack or a natural outbreak depends on epidemiological warning networks and the individual clinical/laboratory expertise of medical personnel, because diagnostic procedures are the same for disease that is caused deliberately and for infections that occur naturally.25 During a crisis or outbreak an MoH may involve the services of its internal agencies or refer the matter to international organisations such as World Health Organisation (WHO) or non-governmental organisations (NGOs) for relevant action and to obtain support. Outbreaks of rare diseases are unpredictable and local health personnel may fail to recognise the early signs at the onset of a major epidemic, mostly because of lack of relevant skills. When this happens, people with contagious infections are allowed to move freely, putting others at risk. Corpses may be released for burial without a public health caution. When field workers in remote locations suspect a rare infectious disease, the referral/reference centres in the cities may not always have the facilities and reagents for some required tests. Samples then have to be sent abroad for testing to positively identify the infecting agents. This takes time and makes the management of the disease outbreak even more challenging as medical personnel have to deal blindly with unknown agents until identification details come from abroad. Consultation between operators is complicated by distance. Epidemic situations are always of concern to the members of public as well as the health professionals. The ministry of health is usually under pressure to do its best, a task made more difficult by the lack of resources in many -developing countries. Payment for health services by the users in some countries26 is a further impediment, as many cannot afford these costs. It is therefore in the interest of society that certain services should not be charged for, as this provides an incentive for people to seek treatment.27 The other impediment to effective public health management is the complete lack of infrastructure in some areas in developing countries. Sick people often die before they reach -hospitals. Poor communication means that outreach by public health educators is difficult and requires additional resources. Radio broadcasts could be of great help, but this service is not -developed either. Use of early warning systems such as weather forecasts and satellite imaging to predict and contain outbreaks should be part of the health management strategy. Heavy rains have been noted to be of key importance in disease outbreaks.28 Many epidemics are associated with extended heavy rains and include both vector-borne and water-borne diseases. The relationship between heavy rains and disease outbreaks could help to identify incidents of deliberately caused disease. The outbreak of major diseases under ordinary climatic conditions should be regarded with suspicion and infecting organisms studied further. Biotechnology trends in eastern Africa The extent of development of biotechnology and scientific research centres differs among the countries in eastern Africa. Most government and private research institutes are free from regulation at operational level and set and control their own research agendas. Institutes are trusted to ensure that only ethical research is conducted. In some countries there is a great deal of collaboration between national and international organisations, which facilitates transparency. In a vibrant biotechnology community, it is possible that unauthorised research can be conducted without the knowledge of the responsible authorities, for example the controversial HIV/AIDS research in humans done without the authority of the Kenya Medical and Licensing Board.29 Biomedical research should be managed to ensure that its applications are for peaceful purposes only.30 The core of future biological warfare threat will probably not consist of a large weapon stockpile, but will probably be the capacity to produce weapons (and their antidotes or phylaxis) on a large scale in a short time or in a crisis. Biotechnology may improve biological warfare capabilities through process and product improvement. This product improvement may involve modifications of pathogens through genetic engineering or through the creation of novel agents and vectors as well as through the development of new equipment for analysis and production. The process of improvement relates to the way agents are manufactured. Optimisation of procedure could lead to production of larger batches within very limited time or the use of small, less conspicuous equipment that is easier to hide in legitimate installations and activities. Genetically modifying existing pathogens may make them more virulent and resistant to drugs and render these agents resistant to environmental stress such as ultra-violet radiation and meteorological conditions after their release to the environment. It is therefore important to have controls in place that will make it less likely for biotechnology to be used to develop or improve biological weapons.31 The level of deliberate disease threat in -eastern Africa A deliberate disease threat assessment is needed to reduce the uncertainty that currently permeates debate over biological terrorism. Undertaking such a threat assessment is important in the current environment where the public feels insecure and limited resources are available to improve the situation. An analysis of the threat of use of biological weapons would include identifying which groups or individuals might pose a threat, which agents might be used, how
[CONTINUED]
an attack might be carried out, what motivates groups or individuals to use such weapons and which areas would be targeted. Answers to these questions will lead to the development of a number of possible scenarios. The level of threat is a reflection of the will to use these agents, and not just a technical issue of how to use them. All countries in eastern Africa face some level of threat because of the conflicts and insecurity in the region as well as the easy access to infectious materials. The impact of the use of biological weapons would be most direct on clinical -microbiologists. If a terrorist attack with a biological agent were to occur, medical microbiology laboratories would be instrumental in helping to detect and identify the agent and in alerting authorities. Referral centres should have all necessary resources to support the field laboratories. Although Bacillus anthracis has received a great deal of publicity as a potential biological weapon, other organisms should not be ignored. Terrorist activities Terrorist groups exist to promote religious, ethnic, political (ideological) or economic causes. Acts of biological terrorism could therefore have political, religious, ideological or criminal motives and could conceivably be planned by groups or a single individual or be part of state-sponsored terrorist activities The activities leading to the 1998 American embassy bombings in Kenya and Tanzania were well coordinated and planned. This trend has continued with most recent attacks across the world. Various attacks are timed to take place simultaneously and on multiple targets. This indicates that terrorist groups make extensive plans for these activities. It is now known that the suspected perpetrators can be citizens of one or different countries, which demonstrates the capacity of these groups to successfully recruit members and execute plans undetected by law enforcement agencies. This was true of the events of 11 September 2001 in the United States. When compared to other weapons, the acquisition, storage and transportation of -biological weapons could be considerably easier. Competent undergraduate students could readily master viral, bacterial culture methods and simple genetic engineering. It is possible that a group or individuals with appropriate training could produce lethal weapons in adequate amounts and then disseminate them in a manner that would result in thousands of casualties and widespread panic. Outbreaks of infectious diseases are a common occurrence in eastern Africa and the region suffers from insecurity owing to countless conflicts. This makes the threat of the use of biological weapons in this region something that has to be considered by the relevant -government departments. In addition, the -distinction between national and global threats is artificial, as infectious agents do not observe the divide. Adequate public health surveillance and response are solutions to preparing for biological warfare events. Only long-term planning and funding can sustain such a global undertaking, which has to be internationally financed and managed. Infectious diseases with no known prophylactic remedies will continue to infect travellers and local people and remain a possible biological weapon.32
A bioterror attack would cause human extinction—it outweighs nuclear war.
Richard Ochs, Member, Depleted Uranium Task Force, Military Toxics Project; former President, Aberdeen Proving Ground Superfund Citizens Coalition; Member, Chemical Weapons Working Group, Freelance Writer, 6/9/02, Free From Terror, “Biological Weapons Must Be Abolished Immediately,” http://www.freefromterror.net/other_articles/abolish.html
Of all the weapons of mass destruction, the genetically engineered biological weapons, many without a known cure or vaccine, are an extreme danger to the continued survival of life on earth. Any perceived military value or deterrence pales in comparison to the great risk these weapons pose just sitting in vials in laboratories. While a "nuclear winter," resulting from a massive exchange of nuclear weapons, could also kill off most of life on earth and severely compromise the health of future generations, they are easier to control. Biological weapons, on the other hand, can get out of control very easily, as the recent anthrax attacks have demonstrated. There is no way to guarantee the security of these doomsday weapons because very tiny amounts can be stolen or accidentally released and then grow or be grown to horrendous proportions. The Black Death of the Middle Ages would be small in comparison to the potential damage bioweapons could cause. Abolition of chemical weapons is less of a priority because, while they can also kill millions of people outright, their persistence in the environment would be less than nuclear or biological agents or more localized. Hence, chemical weapons would have a lesser effect on future generations of innocent people and the natural environment. Like the Holocaust, once a localized chemical extermination is over, it is over. With nuclear and biological weapons, the killing will probably never end. Radioactive elements last tens of thousands of years and will keep causing cancers virtually forever. Potentially worse than that, bio-engineered agents by the hundreds with no known cure could wreck even greater calamity on the human race than could persistent radiation. AIDS and ebola viruses are just a small example of recently emerging plagues with no known cure or vaccine. Can we imagine hundreds of such plagues? HUMAN EXTINCTION IS NOW POSSIBLE. Ironically, the Bush administration has just changed the U.S. nuclear doctrine to allow nuclear retaliation against threats upon allies by conventional weapons. The past doctrine allowed such use only as a last resort when our nation's survival was at stake. Will the new policy also allow easier use of US bioweapons? How slippery is this slope? Against this tendency can be posed a rational alternative policy. To preclude possibilities of human extinction, "patriotism" needs to be redefined to make humanity's survival primary and absolute. Even if we lose our cherished freedom, our sovereignty, our government or our Constitution, where there is life, there is hope. What good is anything else if humanity is extinguished? This concept should be promoted to the center of national debate.. For example, for sake of argument, suppose the ancient Israelites developed defensive bioweapons of mass destruction when they were enslaved by Egypt. Then suppose these weapons were released by design or accident and wiped everybody out? As bad as slavery is, extinction is worse. Our generation, our century, our epoch needs to take the long view. We truly hold in our hands the precious gift of all future life. Empires may come and go, but who are the honored custodians of life on earth? Temporal politicians? Corporate competitors? Strategic brinksmen? Military gamers? Inflated egos dripping with testosterone? How can any sane person believe that national sovereignty is more important than survival of the species? Now that extinction is possible, our slogan should be "Where there is life, there is hope." No government, no economic system, no national pride, no religion, no political system can be placed above human survival. The egos of leaders must not blind us. The adrenaline and vengeance of a fight must not blind us. The game is over. If patriotism would extinguish humanity, then patriotism is the highest of all crimes.
Disease surveillance is the most critical internal link to fighting bioterror—it would provide early warnings and other information necessary to solve.
Joseph P. Dudley, Ph.D., Biologist; Wildlife Ecologist; former Diplomacy Fellow, American Association for the Advancement of Science; former U.S. Peace Corps volunteer, 11/04, BioScience, Volume 54, Issue 11, “Global Zoonotic Disease Surveillance: An Emerging Public Health and Biosecurity Imperative,” http://www.bioone.org/perlserv/?request=get-document&issn=0006-3568&volume=054&issue=11&page=0982bchang
In addition to the threats presented by emerging and rapidly evolving natural disease organisms are those posed by laboratory cultures of genetically modified, weaponized strains of disease pathogens created and developed for use as biological weapons against humans, domesticated livestock, or crops. The anthrax “letter bomb” attacks of September–October 2001 demonstrated the critical need for recognizing that zoonotic disease surveillance and information systems are important elements of our public health and homeland security infrastructure, the nation's first line of defense and response against terrorist attacks involving bioweapon diseases (Dudley 2003). The deliberate or accidental release of weaponized disease pathogens could have devastating direct effects on biodiversity and agricultural productivity—and possibly even more devastating indirect effects on wildlife, including some endangered species, should these become targeted for extirpation because they could become reservoirs or vectors of bioweapon disease pathogens. There is currently no single entity within the government with “command and control” responsibility and regulatory authority for managing the growing nationwide health problems associated with diseases that are passed between wildlife, domesticated animals, and humans (Benjamin et al. 2003). Federal agencies in the United States that have a role in the international monitoring of zoonotic and animal diseases of public health significance, or regulatory authority over potential means through which such diseases could be introduced from overseas, include the US Department of Agriculture's Animal and Plant Health Inspection Services, the Centers for Disease Control and Prevention, the US Public Health Service, the US Fish and Wildlife Service, the US Geological Survey, the Department of Homeland Security, the Department of the Army, and the Department of Defense. Each of these federal agencies has at least two, and in some instances four or more, different component organizations involved in the prevention, monitoring, surveillance, evaluation, identification, or control of zoonotic pathogens or foreign animal diseases. International organizations, multilateral organizations, nongovernmental organizations, and national organizations involved in zoonotic disease surveillance monitoring efforts include the World Health Organization, the United Nations Food and Agriculture Organization, the World Organisation for Animal Health (formerly known as the Office International Epizooties, or OIE), the IUCN–World Conservation Union, and the newly chartered European Centre for Disease Prevention and Control. Although there is considerable cooperation and collaboration among individuals within the infectious disease surveillance and response communities, the degree of formal organizational collaboration and coordination is frequently limited. None of these entities has the mandate or mechanisms to actively seek out and disseminate information on emerging wildlife diseases and zoonoses to all interested public and private sector organizations and agencies. Those government agencies and multilateral organizations that do perform such functions typically operate under institutional or diplomatic constraints that do not permit the dissemination of critically important “unconfirmed” information on disease outbreaks. Yet such information could constitute an early warning system for diseases such as avian influenza or citrus sudden-death virus, for which the confirmation of outbreaks through official channels may be suppressed. Governments may, for example, seek to avoid externally imposed bans on the export of economically important animal or plant products, as happened with the pandemic outbreaks of avian influenza in Asia during 2003 and 2004. Decisionmakers and governments must be encouraged to achieve greater levels of effectiveness in the surveillance and monitoring of infectious diseases in humans, wildlife, crops, and livestock. Information technology tools and methods now available can enhance communication and coordination among all stakeholders in the wildlife health, agriculture, and public heath sectors—including federal and state government agencies, multilateral organizations, the public health community, nongovernmental organizations, private sector corporations, and scientific and professional organizations. For such efforts to be effective, however, clear policy mandates must be in place to encourage and ensure the rapid worldwide sharing and dissemination of information on infectious disease outbreaks.
Advantage Two—Avian Flu
A human outbreak is extremely probable in Africa—lack of surveillance means it’ll slip under the radar until it’s too late to contain.
Risk assessment for Africa Outbreaks in poultry: Significance for human health The arrival of highly pathogenic H5N1 avian influenza on the African continent would be of great concern for human as well as animal health. Though the densities of human and poultry populations are generally lower in Africa than in south-east Asia, the poultry production systems have many similarities which could create multiple opportunities for human exposure, if outbreaks occur in African poultry. In Africa, many households keep backyard flocks which often mingle freely with wild birds. Most such flocks scavenge for food, often entering households or sharing outdoor areas where children play. With few exceptions, notably in large commercial farms, surveillance for avian disease is non-existent. Nutrition of the birds is poor and high mortality is common, increasing the likelihood that outbreaks of H5N1 will be missed. Few governments are in a position to offer support for disease control or compensation for lost birds, thus further discouraging early and open reporting. As experience in Asia has shown, late detection of outbreaks increases the likelihood that the virus will become endemic. Deaths of large numbers of poultry, whether due to disease or culling for control purposes, would deprive already impoverished populations of an important source of dietary protein. Human cases In Africa, the risk of human infection from an avian H5N1 virus can be expected to be similar to that seen in Asia. To date, the majority of human cases in Asia have been linked to close contact with infected domestic birds, with especially high risks thought to occur during home slaughter, defeathering, butchering and preparation for cooking. Consumption of inadequately cooked poultry and poultry products (including eggs and blood) is an additional risk. African households, especially in rural areas, traditionally 4 slaughter and consume birds when signs of illness appear in backyard flocks. As in Asia, such practices could prove difficult to change. The occurrence of human cases, even sporadic, would create enormous new challenges for health systems and services that are already fragile and overburdened. Early detection of human cases is unlikely. Surveillance systems are weak and unlikely to pick up cases of a disease with symptoms similar to those of common illnesses. Health service, human and financial resources have been overwhelmed by the demands of AIDS, tuberculosis and malaria. Laboratory confirmation of human H5N1 infections requires technology, finances and trained personnel. Management of H5N1 patients is very demanding. Infection control in most hospitals is difficult to introduce and sustain. Sporadic cases of H5N1 infection and the frequent reluctance of residents to comply with recommended reporting and isolation measures during outbreaks of severe disease could push fragile health systems close to the brink of collapse. Surveillance systems are not sufficiently sensitive to clusters of human cases, although they constitute a critical early warning signal that the virus is improving its transmissibility. Africa has some well-equipped laboratories, but these might rapidly prove inadequate should large numbers of samples need to be tested rapidly.
Spillover is guaranteed—due to globalization, avian flu will quickly spread out of Africa to the rest of the world if not contained.
Joseph P. Dudley, Ph.D., Biologist; Wildlife Ecologist; former Diplomacy Fellow, American Association for the Advancement of Science; former U.S. Peace Corps volunteer, 11/04, BioScience, Volume 54, Issue 11, “Global Zoonotic Disease Surveillance: An Emerging Public Health and Biosecurity Imperative,” http://www.bioone.org/perlserv/?request=get-document&issn=0006-3568&volume=054&issue=11&page=0982bchang
The proliferation of disease pathogens that can infect humans, livestock, wildlife, and other animals increasingly threatens biodiversity and environmental security, and has collateral impacts on human health and international commerce. Globalization means that physical distance from outbreaks of zoonotic diseases—even distances spanning half the globe—can no longer be considered a safeguard against infection from those diseases. The unexpected resurgence in human deaths from H5N1 avian influenza in Vietnam and Thailand during August and September 2004 and the first evidence of direct human-to-human transmission of this potentially deadly zoonotic disease clearly demonstrate the need for international cooperation and collaboration in the identification, monitoring, and control of zoonotic diseases around the globe. The SARS (severe acute respiratory syndrome) virus, H5N1 avian influenza virus, Nipah virus, and Ebola virus are only the most widely publicized examples of a growing list of emerging infectious diseases transmitted between wild animals and human beings, often with domesticated livestock or human commensals such as rats and pigeons involved in the chain of infection and transmission (Guan et al. 2003). The globalization of industrial livestock production and the rapidly expanding international trade in animals and animal products from wild and domesticated species are fostering the emergence and global proliferation of new zoonotic diseases with the ability to pass between and among humans, wildlife, and domesticated animals. Recent increases in the emergence and proliferation of pathogens are being driven by human transformations of natural landscapes for agriculture and livestock production, human selection through indiscriminate or inappropriate uses of antibiotics, deliberate and accidental introductions of exotic invasive alien species, and a $6 billion global trade in exotic animals and plants. Rapidly expanding and increasingly concentrated populations of humans and livestock are fostering the emergence of virulent zoonotic pathogens that may cause fatal disease in humans and animals. Diseases like tuberculosis and polio, which were once thought susceptible to global eradication, are reclaiming lost ground, while viral diseases of humans and animals are evolving new strains that go undetected and thus thwart regional and global vaccination programs. The ancient scourges of anthrax and plague are proliferating once again in areas of Africa and Asia beset by drought, poverty, war, and civil strife. The history of rinderpest in Africa, where the devastating loss of livestock and game animals caused widespread famine, shows that outbreaks of disease in animals may prove just as lethal for indigenous peoples and pastoral communities as human diseases like smallpox or pneumonic plague. The 2003–2004 avian influenza pandemic in Asia was unprecedented in its severity and geographic scope, with exceptionally high virulence in avian as well as human populations. Death rates among confirmed human victims of the H5N1 avian influenza virus in Vietnam and Thailand (> 70 percent mortality) are comparable to those reported among human cases of the Ebola virus in central Africa and Nipah virus in Bangladesh. Emerging and endemic zoonotic diseases are demonstrably no longer a safely distant, third-world health phenomenon. The past several years have seen an astounding resurgence of zoonotic diseases as public health threats in the United States, including Emergence of tick-borne Lyme disease as a significant public health problem in the suburban landscapes of the eastern United States The appearance of West Nile virus in New York City and its rapid spread throughout the temperate regions of North America and southward into the Caribbean and Central America, with significant impacts on populations of wild birds and mammals, horses, and humans
The introduction of monkeypox, a formerly obscure zoonotic disease from the rain forests of central Africa, into the United States through the exotic pet trade .
Disease surveillance is necessary to prevent avian flu from secretly spreading without detection, which would make it uncontainable.
The United States’ efforts to protect its citizens from deadly pandemic influenza will be only as successful as its efforts to protect citizens of other nations from the avian influenza. The bird flu virus H5N1 has now appeared in birds some 30 nations. “The best defense of the United States is what we do internationally,” said Kent Hill, assistant administrator for global health at the U.S. Agency for International Development (USAID) in testimony before a U.S. House Appropriations subcommittee March 2. Explaining the potential for avian influenza to escalate rapidly into a lethal, fast-moving human disease, U.S. Centers for Disease Control and Prevention Director Julie Gerberding said, “We are only as strong as our weakest link.” The warning made an impression on members of the Foreign Operations, Export Financing and Related Programs Subcommittee. “That’s disturbing,” said Representative Don Sherwood, a Pennsylvania Republican. “There are places in the world where [pandemic influenza] could get a pretty good head start on us and we wouldn’t know it.” The United States, working in partnership with other nations, has undertaken a variety of initiatives to help improve the capability for disease surveillance and detection in other nations in a shared strategy that has emerged from a series of international meetings over the last six months.
Every day the risk of mutation increases. Early detection through surveillance is critical to solve the disease.
The dangerous H5N1 avian influenza virus has become endemic in birds in Asia and has been moving steadily westward. It also can infect humans, and the World Health Organization has documented 174 cases over the last two years, resulting in 94 deaths. Direct contact between humans and ailing poultry has been determined to be the cause of all but one of those cases. Health officials warn that the virus could mutate to become easily transmissible to and among humans. That might lead to pandemic influenza with the potential to cause millions of deaths and widespread social and economic turmoil. As more and more birds are exposed in more and more places, the opportunities for that mutation to occur increase. The earliest possible detection and elimination of infection in birds are considered the best strategy for pandemic prevention. Since the appearance of H5N1 in Nigeria in February, Hill said USAID has worked to recruit and train local organizations that have helped wage the battle against polio now to become involved in bird flu surveillance. Unusual fatalities among birds were spotted in Nigeria in January, Hill said, but initially were misdiagnosed and attributed to another less serious disease. The anecdote demonstrates that capable surveillance is a problem, and the international assistance effort is just beginning a long process to upgrade it, Hill said.In Cambodia, Gerberding said, CDC is using a similar strategy to solicit the help of ordinary people. Every village now has a veterinarian’s aide who has been trained to spot sick birds; each is equipped with a cell phone to call regional or national health authorities if signs of disease start appearing in backyard poultry. Members of the appropriations subcommittee, who will be influential in future spending decisions on bird flu overseas assistance, expressed concern about whether current U.S. plans will do enough to help build disease surveillance and containment. About $6.5 million now is earmarked for assistance to Africa, and some members questioned whether that amount will be adequate now that outbreaks have been detected in animals in both Nigeria and Niger. Leaders of U.S. government health agencies acknowledged that review of the plan will be an ongoing task, requiring constant vigilance.
Once mutated, avian flu would kill billions and wreck the global economy.
Chandra ’04 (Mr. Satish Chandra is the Deputy National Security Advisor of India – Center for Strategic Decision Research – Global Security: A broader Concept for the 21st Century -- May 7th)
Indirect threats to global security arise not from issues customarily associated with security, such as war, regional conflict, civil strife, proliferation of nuclear weapons, and terrorism, but from issues traditionally not considered to significantly impact security, such as climate change, disease, poverty, and economic inequities. The latter threats could perhaps more appropriately be termed nonconventional rather than indirect, since failure to address them can have as disastrous an impact on our existence and well-being as the failure to address more conventional threats. I will highlight the grave dangers posed by two of these threats, climate change and flu pandemics, and outline briefly what we can and need to do. Because both of these dangers are able to inflict on us, during the next few years, devastation of an order hitherto never visited on mankind, I would like to paint two entirely plausible hypothetical scenarios to bring home the gravity of the situation. It is 2015. Despite much debate and warning, the world has done little to address the buildup of greenhouse gases and the consequent acceleration of global warming, which is accompanied by increasingly unpredictable world weather patterns. Extreme heat, storms, and droughts have created havoc for farmers. Mega-droughts are affecting major granaries. The world’s agricultural production and freshwater resources are seriously stretched, reducing the planet’s carrying capacity. Deaths from famine and drought are in the hundreds of thousands. Violent and frequent storms are lashing Western Europe, leading to the abandonment of low-lying cities such as The Hague. Rising sea levels have made countries such as Bangladesh nearly uninhabitable, resulting in mass migration. This scenario, as frightening as it is, pales in comparison with what could overtake us by 2007 if the highly pathogenic form of bird flu “H5N1” becomes transmittable human to human; all it would take for this to happen is a simple gene shift in the bird flu virus, which could happen any day. In a globalized world linked by rapid air travel, the disease would spread like a raging forest fire. If it did, it would overwhelm our public health system, cripple our economies, and wipe out a billion people within the space of a few months—a 60 percent mortality rate is estimated.
We must act now—avian flu is already on the move in Africa—implementing surveillance immediately is the only way to solve.
Since sub-Saharan Africa’s first reported outbreak of highly pathogenic avian influenza (HPAI) H5N1 in Nigeria in February 2006, the disease has spread to birds in Burkina Faso, Cameroon, Côte d’Ivoire, Djibouti, Ghana, Niger and Sudan. As of May 2007, the World Health Organization (WHO) had confirmed one human fatality in Nigeria and one non-fatal human case in Djibouti. The deaths or infections of hundreds of thousands of birds are causing social and economic disruption with implications for African food supplies and incomes, and pose serious risks to human health through exposure to infected birds. The United States combats HPAI H5N1 in sub-Saharan African nations by working with governments and regional entities, and with international organizations such as the WHO, the Food and Agriculture Organization (FAO), UNICEF and the World Organization for Animal Health (OIE). Through the International Partnership on Avian and Pandemic Influenza, the United States works to elevate the issue on national agendas – and to coordinate efforts between affected nations in sub-Saharan Africa and donors. To assist in responding to HPAI H5N1 outbreaks and in preparing for a possible human pandemic, the United States is supporting efforts in much of sub-Saharan Africa through bilateral and regional programs.
Economic collapse culminates in a US-China nuclear war.
Mead 04 – Senior Fellow at Council on Foreign Relations
[Walter Russell, “America's STICKY Power,” Foreign Policy, Mar/Apr, Proquest]
Similarly, in the last 60 years, as foreigners have acquired a greater value in the United States-government and private bonds, direct and portfolio private investments-more and more of them have acquired an interest in maintaining the strength of the U.S.-led system. A collapse of the U.S. economy and the ruin of the dollar would do more than dent the prosperity of the United States. Without their best customer, countries including China and Japan would fall into depressions. The financial strength of every country would be severely shaken should the United States collapse. Under those circumstances, debt becomes a strength, not a weakness, and other countries fear to break with the United States because they need its market and own its securities. Of course, pressed too far, a large national debt can turn from a source of strength to a crippling liability, and the United States must continue to justify other countries' faith by maintaining its long-term record of meeting its financial obligations. But, like Samson in the temple of the Philistines, a collapsing U.S. economy would inflict enormous, unacceptable damage on the rest of the world. That is sticky power with a vengeance. The United States' global economic might is therefore not simply, to use Nye's formulations, hard power that compels others or soft power that attracts the rest of the world. Certainly, the U.S. economic system provides the United States with the prosperity needed to underwrite its security strategy, but it also encourages other countries to accept U.S. leadership. U.S. economic might is sticky power. How will sticky power help the United States address today's challenges? One pressing need is to ensure that Iraq's econome reconstruction integrates the nation more firmly in the global economy. Countries with open economies develop powerful trade-oriented businesses; the leaders of these businesses can promote economic policies that respect property rights, democracy, and the rule of law. Such leaders also lobby governments to avoid the isolation that characterized Iraq and Libya under economic sanctions. And looking beyond Iraq, the allure of access to Western capital and global markets is one of the few forces protecting the rule of law from even further erosion in Russia. China's rise to global prominence will offer a key test case for sticky power. As China develops economically, it should gain wealth that could support a military rivaling that of the United States; China is also gaining political influence in the world. Some analysts in both China and the United States believe that the laws of history mean that Chinese power will someday clash with the reigning U.S. power. Sticky power offers a way out. China benefits from participating in the U.S. economic system and integrating itself into the global economy. Between 1970 and 2003, China's gross domestic product grew from an estimated $106 billion to more than $1.3 trillion. By 2003, an estimated $450 billion of foreign money had flowed into the Chinese economy. Moreover, China is becoming increasingly dependent on both imports and exports to keep its economy (and its military machine) going. Hostilities between the United States and China would cripple China's industry, and cut off supplies of oil and other key commodities. Sticky power works both ways, though. If China cannot afford war with the United States, the United States will have an increasingly hard time breaking off commercial relations with China. In an era of weapons of mass destruction, this mutual dependence is probably good for both sides. Sticky power did not prevent World War I, but economic interdependence runs deeper now; as a result, the "inevitable" U.S.-Chinese conflict is less likely to occur.
[Insert Strait Times 2K]
Disease surveillance would allow us to track and contain the avian flu.
Declan Butler, Chevalier, France's National Order of Merit; European Correspondent and Writer, Nature Magazine; Ph.D., Biology, Queen’s University, 3/1/06, Nature, “Disease Surveillance Needs a Revolution,” http://www.nature.com/news/2006/060227/full/440006a.htmleveryone
With avian flu spreading around the world at a frightening rate, scientists are welcoming an international proposal for state-of-the-art labs to monitor emerging diseases in developing countries. But they add that the bird-flu crisis has exposed glaring deficiencies that demand a radical rethink of the world's veterinary and disease-surveillance systems. Avian flu is now endemic across large parts of Asia, and in the past few weeks has exploded across Europe and into Africa. "H5N1 has focused the spotlight of the world on disease surveillance, and it's showing up all the pimples and warts," says Bill Davenhall, who develops health mapping schemes for countries and is head of health at ESRI, a geographic information systems company in Redlands, California. Developing countries, in particular, lack decent human-disease surveillance, and animal monitoring is often virtually nonexistent, with few basic laboratory and epidemiological resources available. "On the ground in Indonesia, there is no systematic programme at all," says Peter Roeder, a field consultant with the United Nations' Food and Agriculture Organization (FAO). "It's just a bloody mess." Global danger It is a problem that the developed world cannot ignore, because a disease that emerges in Bangkok or Jakarta could ultimately trigger a global disaster. So researchers at the US Department of Defense have suggested setting up a network of high-tech labs in developing countries to monitor cases of infectious disease (see page 25). The labs would be modelled on the US network of infectious-disease labs, such as the naval research unit NAMRU-2 in Jakarta. But they would be funded by the international community to avoid the local distrust that has often hampered labs run by the US military. Such a network could vastly speed up and improve the diagnosis of viruses such as H5N1 when outbreaks occur, says Roeder. He points out that misdiagnosis of H5N1 as Newcastle disease in recent outbreaks in Nigeria and India led to long delays in control measures. Mark Savey, an epidemiologist who heads animal health at France's food-safety agency, also welcomes the proposal, but cautions against the "mirage of technology" in surveillance. "You don't need satellites, PCR and geographic information systems to fight outbreaks," he says. The labs' top priority should be building large teams of local staff, who are familiar with the region and its practices, he argues. "If you do not have that, then surveillance will stay in the Middle Ages." Savey recalls his trip to Russia last summer as part of a European team investigating outbreaks of avian flu. "You have a paper Michelin map; you have people who speak the language; you put red circles on outbreaks; and you use a pen and paper to compare them with things like the dates of market openings, and with how outbreaks line up with railways." Such local knowledge is crucial to interpreting data, he says. "If you don't know what the Trans-Siberian Express is like, with people cooped up for days, exchanging chickens and eggs at every stop, you would never guess that it was the Trans-Siberian that mainly spread avian flu across Russia." Roeder agrees that the focus must be local. "No amount of setting international guidelines and publishing global action plans is going to help when you have an organization within the country that doesn't know what to do," he says. Back to basics But many feel that alongside setting up local centres, epidemiology needs a fundamental overhaul. Even in developed countries, the field has been chronically underfunded, says Antoine Flahault, director of Sentinelles, France's national disease surveillance network. He adds that he is jealous of the multimillion-dollar satellites that climate scientists enjoy and the powerful accelerators being built for physicists. In comparison, epidemiologists "are still in the nineteenth century", he says. Flahault points out that his own national flu-monitoring system relies on a few hundred volunteer doctors submitting patient data to an online database. From these data, Flahault's team tries to build up a picture of disease across the country, spotting outbreaks and predicting when the year's flu season will hit. The 122-city programme run by the US Centers for Disease Control and Prevention is the only one in the world where disease reports are made in real time, Flahault points out. And such lack of data prevents the field from developing sophisticated models of communicable disease. "It's as if we were trying to study the weather, but collected data only when there was a heatwave or storm," he says. Ward Hagemeijer, the bird-flu programme manager at Wetlands International in Wageningen, the Netherlands, also complains of the general lack of resources. He has been on recent missions to sample H5N1 in affected countries, but says he has been unable to get his African samples sequenced because certified labs have been too busy analysing samples from European outbreaks.
Advantage Three—Genocide
Disease surveillance is necessary to predict and prevent genocide before it occurs—the work involved in the surveillance of diseases can be easily applied to prevent violence.
David P. Eisenman, assistant professor for the Division of General Internal Medicine and Health Services Research at the UCLA School of medicine, 2002, “Genocide” Encyclopedia of public health, http://health.enotes.com/public-health-encyclopedia/genocide [Nathan]
The precursors, processes, and consequences of genocide are increasingly being understood, and public health contributes to this understanding in a distinct manner from other disciplines, such as the law profession and the human rights field. Specifically, public health brings to the study of genocide the unique tools of epidemiology, which is the study of the distribution of disease and the factors associated with a disease within a population. Since public health views a specific population or group of human beings in an ecological model that includes the institutions (e.g., paramilitary organizations) and the objects (e.g., weapons of genocide) they have created, it is only natural that public health views genocide in this manner, too. Thus, public health professionals can examine genocide as a disease, along with social and behavioral factors that correlate with the disease, and may even cause it. The work that public health professionals do to examine, prevent, and mitigate genocide can be understood in terms of the three traditional core functions of public health: assessment, policy development, and assurance of services. Assessments can be performed through data collection and analysis intended to identify, document, and notify the public about potential or ongoing genocide. Here the public health principles of disease and injury surveillance can be applied to violence against a population, and the traditional tools of public health—such as case reports and surveillance studies—are well suited to this function. A genocide may have early warning signs that public health professionals can detect, such as escalating violence, increased refugee flows out of a country, and increasing systematic discrimination. In those cases where a war strategy targets the health of an entire group of people, public health professionals are best able to recognize the nature of the genocide.
Moreover, this system allows the prediction of refugee migrations, which is a critical internal link into solving massive manifestations of violence, including civil wars and genocide.
Jeff Grabmeier assistant director of research communications at Ohio State University, 9/29/98, “Warning Systems may help predict potential refugee crises”, http://researchnews.osu.edu/archive/refugee.htm [Nathan]
COLUMBUS, Ohio -- When natural disasters like hurricanes or floods threaten, experts can usually give people early warnings so they have time to prepare. Now social scientists are working to develop similar early warning systems that can forecast political and social disasters that are sometimes deadlier and more costly than natural calamities. In one new model, researchers have identified some of the important factors that may predict refugee migrations within a country or from one country to another. “Refugee migrations are not random occurrences -- they stem from political and social problems that can be predicted,” said Craig Jenkins, a professor of sociology and a researcher at Ohio State University’s Mershon Center for International Security. “We think it is as important to predict refugee migrations as it is to predict hurricanes.” Jenkins developed the model with Susanne Schmeidl from the Swiss Peace Foundation in Bern, Switzerland. The model will be published this year as a chapter in the book Preventive Measures: Building Risk Assessment and Crisis Early Warning Systems (John Davies and Ted Gurr, editors; Rowman and Littlefield, 1998). Using 1971-1995 data from the United Nations and other sources, Jenkins and Schmeidl identified both long-term, root causes of refugee migrations as well as the more immediate factors that sparked the crises. They found that the major root causes included weak governments, long-standing ethnic antagonisms and inequality, and poverty linked to economic dependence on other countries. Large migrations were often immediately preceded by some type of generalized violence: civil wars, genocide or politicide in the affected countries, or foreign military interventions. One unexpected finding was that population growth and density in a country was not related to refugee crises. “Many policymakers have argued that population pressure is one of the central sources of humanitarian crises, but we didn’t find that,” Jenkins said. “It may be a general symptom of less-developed countries, but not of crisis-prone countries in particular.” Although most of the factors associated with refugee problems are not surprising, Jenkins said there has never been a systematic effort to collect all the relevant data and use it to forecast -- and possibly prevent -- social or political disasters. The United Nations and various humanitarian agencies currently do international monitoring to predict when and where disasters will occur, Jenkins said. But they use the information mostly as a crisis management tool, to plan for dealing with the disasters. “We hope to develop warning systems that are more complete and accurate so that we can identify potential trouble spots long before they erupt and possibly prevent problems from occurring,” he said. “Of course, compared to forecasting a hurricane, there is a much larger margin of error when you’re trying to predict forced migrations. But we’re taking small steps that may eventually help us prevent or at least mitigate some of these social and political disasters.” There is a huge need to predict and prevent refugee problems, according to Jenkins. In 1970, there were about 14 million people worldwide who were displaced from their homes, either to other countries or within their own. By 1990, that number had skyrocketed to 39 million. The number dropped slightly between 1990 and 1995. Jenkins said he is now working to improve the model in order to make it more accurate. One avenue he is exploring is identifying the factors that lead to “political meltdown” in a country. Political instability and violence in a country often lead to refugee problems. “The need for humanitarian early warning is great,” he said. “Once political violence has broken out, it’s usually too late to de-escalate the conflict. We need to develop better information on the root causes, especially inequalities and ethnic problems. And we also need better information about conflict escalation and the factors that immediately precede refugee migrations.”
We as intellectuals must speak out in public forums against genocide. Continual failure to deal with genocide crushes the human spirit and makes multiple scenarios for extinction inevitable. Our ethic is key to solve all suffering.
Ketels ’96 Associate Professor of English at Temple Universitybchang
Even though, as Americans, we have not experienced “by fire, hunger and the sword”, the terrible disasters in war overtaking other human beings on their home ground, we know the consequences of human hospitality to evil. We know about human perfidy: the chasm that separates proclaiming virtue from acting decently. Even those of us trained to linguistic skepticism and the relativity of moral judgment can grasp the verity in the stark warning, “If something exists in one place, it will exist everywhere.” That the dreadful something warned against continues to exist anywhere should fill us with an inextinguishable yearning to do something. Our impotence to action against the brutality of mass slaughter shames us. We have the historical record to ransack for precedent and corollaries—letters, documents, testaments, books—written words that would even “preserve their validity in the eyes of a man threatened with instant death.” The truths gleanable from the record of totalitarian barbarianism cited in them may be common knowledge; they are by no means commonly acknowledged. They appear in print upon many a page; they have not yet—still not yet—sufficiently penetrated human consciousness. Herein lies the supreme lesson for intellectuals, those who have the projective power to grasp what is not yet evident to the general human consciousness: it is possible to bring down totalitarian regimes either by violence or by a gradual transformation of human consciousness; it is not possible to bring them down “if we ignore them, make excuses for them, yield to them or accept their way of playing the game” in order to avoid violence. The history of the gentle revolutions of Poland, Hungary, and Czechoslovakia suggests that those revolutions would not have happened at all, and certainly not bloodlessly, without the moral engagement and political activism of intellectuals in those besieged cultures. Hundreds of thousands of students, workers, and peasants joined in the final efforts to defeat the totalitarian regimes that collapsed in 1989. Still, it was the intellectuals, during decades when they repeatedly risked careers, freedom, and their very lives, often in dangerous solitary challenges to power, who formed the unifying consensus, developed the liberating philosophy, wrote the rallying cries, framed the politics, mobilized the will and energies of disparate groups, and literally took to the streets to lead nonviolent protests that became revolutions. The most profound insights into this process that gradually penetrated social consciousness sufficiently to make revolution possible can be read in the role Vaclav Havel played before and during Czechoslovakia’s Velvet Revolution. As George Steiner reflects, while “the mystery of creative and analytic genius . . . is given to the very few,” others can be “woken to its presence and exposed to its demands.” Havel possesses that rare creative and analytic genius. We see it in the spaciousness of his moral vision for the future, distilled from the crucible of personal suffering and observation; in his poet’s ability to translate both experience and vision into language that comes as close as possible to truth and survives translation across cultures; in the compelling force of his personal heroism. Characteristically, Havel raises local experience to universal relevance. “If today’s planetary civilization has any hope of survival,” he begins, “that hope lies chiefly in what we understand as the human spirit.” If we don’t wish to destroy ourselves in national, religious or political discord; if we don’t wish to find our world with twice its current population, half of it dying of hunger; if we don’t wish to kill ourselves with ballistic missiles armed with atomic warheads or eliminate ourselves with bacteria specially cultivated for the purpose; if we don’t wish to see some people go desperately hungry while others throw tons of wheat into the ocean; if we don’t wish to suffocate in the global greenhouse we are heating up for ourselves or to be burned by radiation leaking through holes we have made in the ozone; if we don’t wish to exhaust the nonrenewable, mineral resources of this planet, without which we cannot survive; if, in short, we don’t wish any of this to happen, then we must—as humanity, as people, as conscious beings with spirit, mind and a sense of responsibility—somehow come to our senses. N25 Somehow we must come together in “a kind of general mobilization of human consciousness, of the human mind and spirit, human responsibility, human reason.”
Contention Two is Solvency
The United States is uniquely positioned to do disease surveillance due to technical expertise.
(Population and Development Review, March 96, “The National Science and Technology Council on Emerging and Re-emerging Infectious Diseases” Vol. 22, No. 1., JSTOR) [Ram]
A global system for infectious disease surveillance and response will help protect the health of American citizens and people throughout the world. In addition, the improvement of international health is a valuable component of the U.S. effort to promote worldwide political stability through sustainable economic development. Healthy people are more productive and better able to contribute to their countries' welfare. Also, a global disease surveillance and response network will enable the United States to respond quickly and effectively in the event of an attack involving biological or chemical warfare, as the experience gained in controlling naturally occurring microbes will enhance our ability to cope with a biological warfare agent, should the need arise. The release of nerve gas in the Tokyo subway system in March 1995 has underscored our need to be well prepared to counteract deliberate attempts to undermine human health. Thus, the effort to build a global surveillance and response system is in accord with the national security and foreign policy goals of the United States. Moreover, leadership in global infectious disease surveillance and control is a natural role for the United States. American business leaders and scientists are in the forefront of the computer communications and biomedical research communities (both public and private sector) that provide the technical and scientific underpinning for disease surveillance. Furthermore, American scientists and public health professionals have been among the most important contributors to the international efforts to eradicate smallpox and polio.
US action is critical to spur international cooperation which is necessary to solve case.
(Population and Development Review, March 96, “The National Science and Technology Council on Emerging and Re-emerging Infectious Diseases” Vol. 22, No. 1., JSTOR) [Ram]
The challenge ahead outstrips the means available to any one country or to international organizations. The U.S. Government must not only improve its capacity to meet the growing threat of emerging infectious diseases, but also work in concert with other nations and international bodies. Although international efforts must be coordinated to prevent global pandemics, disease surveillance must be the responsibility of each sovereign nation. However, individual governments may not easily share national disease surveillance information, fearing losses in trade, tourism and national prestige. Nevertheless, because U.S. experts are often consulted on problems of infectious disease recognition and control, the U.S. Government is usually informed about major disease outbreaks in other countries, although not always in an official or timely fashion. To ensure that we continue to be notified when an unusual outbreak occurs, we must encourage and support other countries' efforts in national disease surveillance and respond when asked for assistance. We must strive to develop a sense of shared responsibility and mutual confidence in the international effort to combat infectious diseases. There is much room for optimism. If the United States takes the lead, we can expect that other nations will contribute resources to a global surveillance system. Both Canada and the European Union have recently decided- in spite of tight budgets-to provide substantial funds ($7 and $10 million per year, respectively) to strengthen infectious disease surveillance and control. It is also absolutely critical that developing nations be engaged in an international effort that is in their own interests. In May 1995, WHO passed a resolution urging member states "to strengthen national and local programmes of surveillance for infectious diseases, ensuring that outbreaks of new, emerging, and reemerging infectious diseases are identified." Soon after the resolution was drafted, WHO issued a report urging the strengthening of global disease surveillance and control, and encouraging greater use of WHO Collaborating Centers in this endeavor.
Lack of US leadership would destroy all other multilateral efforts at international cooperation.
David P. Fidler, B.A., 1986, University of Kansas; J.D., 1991, Harvard Law School; M. Phil. International Relations, 1988, University of Oxford; B.C.L., 1991, University of Oxford. Associate, Sullivan & Cromwell, London, 1991-93. Associate, Stinson, Mag & Fizzell, Kansas City, 1993-95. Lecturer, University of Oxford, 1990-93; Professor, International Law, Indiana; World authority on bioterrorism, infectious diseases, and foreign investment; Consultant, WHO and US Centers for Disease Control and Prevention, Global Public Health; Advisor, US Department of Defense, Bioterrorism, and to the Federation of American Scientists Working Group on Biological Weapons, Spring 2002, “Bioterrorism, Public Health, And International Law,” Chicago Journal of International Law 7-25 , 23-25, http://academic.udayton.edu/health/syllabi/Bioterrorism/2PublicHealth/PHealth01.htmbchang
B. Global Public Health and Bioterrorism: Whither the United States? The global public health debacle of HIV/AIDS and the general global crisis in infectious diseases led experts in the late 1990s and early 2000s to argue that the United States must become more engaged in global public health. Sometimes these arguments connected public health with national security by claiming that both naturally-occurring infectious diseases and bioterrorism constituted a national security threat to the United States. By and large, the arguments that infectious diseases represented a national security threat made little impact in Washington, DC. The only arguments that resonated in Washington related to bioterrorism and biological weapons proliferation, which represented the most traditional form of national security threats. In the wake of the anthrax attacks, the White House and Congress solidified prior spending patterns by preparing to spend billions of dollars for homeland defense against bioterrorism. This mounting national and homeland security effort will dominate US attitudes toward global public health for the foreseeable future. We may witness a shift in the United States from a weak global perspective on naturally occurring infectious diseases that largely affect other countries to a strong national concern about the malevolent use of pathogenic microbes against Americans. US engagement in global public health will, thus, not stray far from the objective of protecting the homeland from bioterrorism, as evidenced by US participation in the Ottawa Plan, even though millions of people in developing countries will continue to suffer and die annually from infectious diseases unrelated to bioterrorism. As the victim of bioterrorism, the United States understandably needs to focus on homeland defense and the public health contribution to that objective. As people experienced with the bioterrorism debate prior to the anthrax attacks understood, US vulnerability to bioterrorism is enormous. Federal and state governments have almost endless intelligence, law enforcement, and public health work to do to protect Americans from bioterrorism. The combination of the September 11th violence and the anthrax attacks leaves the US government with no choice but to focus energetically on a comprehensive homeland defense. The focus on homeland defense will filter through to US attitudes toward the role of international law in public health. The United States will attempt to use international law to fight bioterrorism rather than to grapple with the global crisis in naturally occurring infectious diseases. Making sure bioterrorism is criminalized globally will supercede the need to build a global infectious disease surveillance system. Given the fusion of public health and national security in the wake of bioterrorism, the United States will not hesitate to use its power, influence, and resources to make the fight against bioterrorism central to its outlook on the role of international cooperation and international law in global public health. Infectious disease problems in the developing world will be even less important to the United States in the post-anthrax world than they were previously. The lack of US leadership and engagement with global public health will handicap efforts by other states, international organizations, and non- governmental organizations to advance multilateral cooperation on global public health problems. Even if the 2001 anthrax attacks prove to be an isolated phenomenon, the experience of bioterrorism on US soil will distract US attention from traditional public health challenges around the world. The slow, frustrating, and incomplete progress made in raising US awareness about the global crisis in infectious diseases in the 1990s may now be another victim of bioterrorism in the United States.
Disease surveillance effectively contains disease through allowing for pattern recognition and basic precautionary procedure—local health workers alone lack necessary skills.
James Thuo Njugana, Master’s Degree in Biotechnology; Writer, Bonn International Center for Conversion, Biological and Chemical Weapons; Member, International Livestock Research Institute, worked on control of trypanosomosis and malaria; Writer, African Security Review [Peer Reviewed], 2005, Institute for Security Studies, African Security Review, Volume 14, Issue 1, http://www.openj-gate.org/Articlelist.asp?Source=1&Journal_ID=103955bchang
Ministries of health (MoHs) across Africa are mandated to deal with all health issues -including budgetary allocations to deal with infectious disease outbreaks. They are -responsible for -containing disease outbreaks wherever they occur in a country. Hospitals and care-giving institutions have a core function owing to their being in a special position to recognise an emerging outbreak of a given disease.24 Early detection of a biological agent attack or a natural outbreak depends on epidemiological warning networks and the individual clinical/laboratory expertise of medical personnel, because diagnostic procedures are the same for disease that is caused deliberately and for infections that occur naturally.25 During a crisis or outbreak an MoH may involve the services of its internal agencies or refer the matter to international organisations such as World Health Organisation (WHO) or non-governmental organisations (NGOs) for relevant action and to obtain support. Outbreaks of rare diseases are unpredictable and local health personnel may fail to recognise the early signs at the onset of a major epidemic, mostly because of lack of relevant skills. When this happens, people with contagious infections are allowed to move freely, putting others at risk. Corpses may be released for burial without a public health caution. When field workers in remote locations suspect a rare infectious disease, the referral/reference centres in the cities may not always have the facilities and reagents for some required tests. Samples then have to be sent abroad for testing to positively identify the infecting agents. This takes time and makes the management of the disease outbreak even more challenging as medical personnel have to deal blindly with unknown agents until identification details come from abroad. Consultation between operators is complicated by distance. Epidemic situations are always of concern to the members of public as well as the health professionals. The ministry of health is usually under pressure to do its best, a task made more difficult by the lack of resources in many -developing countries. Payment for health services by the users in some countries26 is a further impediment, as many cannot afford these costs. It is therefore in the interest of society that certain services should not be charged for, as this provides an incentive for people to seek treatment.27 The other impediment to effective public health management is the complete lack of infrastructure in some areas in developing countries. Sick people often die before they reach -hospitals. Poor communication means that outreach by public health educators is difficult and requires additional resources. Radio broadcasts could be of great help, but this service is not -developed either. Use of early warning systems such as weather forecasts and satellite imaging to predict and contain outbreaks should be part of the health management strategy. Heavy rains have been noted to be of key importance in disease outbreaks.28 Many epidemics are associated with extended heavy rains and include both vector-borne and water-borne diseases. The relationship between heavy rains and disease outbreaks could help to identify incidents of deliberately caused disease. The outbreak of major diseases under ordinary climatic conditions should be regarded with suspicion and infecting organisms studied further.
Disease surveillance is critical to all other methodologies of containing disease—it’s necessary for any system dealing with health.
Mac W. Otten, Jr., MD, MPH, Medical Epidemiologist, African Regional Office (WHO) and Helen Perry, MA, Educational Design Specialist, Division of International Health (CDC), 6/01, World Health Organization Regional Office for Africa and the Centers for Disease Control and Prevention, “Technical Guidelines for Integrated Disease Surveillance and Response in the African Region,” Harare, Zimbabwe and Atlanta, Georgia, USA, http://www.cdc.gov/idsr/focus/surv_sys_strengthening/tech_guidelines-integrated-diseaseENG.pdf//bchang
Communicable diseases are the most common causes of death, disability and illness in the African region. While these diseases present a large threat to the well-being of African communities, there are well-known interventions that are available for controlling and preventing them. Surveillance data can guide health personnel in the decision making needed to implement the proper strategies for disease control and lead to activities for preventing future cases. Surveillance is a watchful, vigilant approach to information gathering that serves to improve or maintain the health of the population. A functional disease surveillance system is essential for defining problems and taking action. Using epidemiological methods in the service of surveillance equips district and local health teams to set priorities, plan interventions, mobilize and allocate resources and predict or provide early detection of outbreaks. Depending on the goal of the disease prevention programme, the surveillance activity objectives guides programme managers towards selecting data that would be the most useful to collect and use for making evidenced-based decisions for public health actions. A disease control program may want to know what progress is being made with its prevention activities. The program collects age and vaccination statues for cases of vaccine-preventable diseases. If the program’s goal is to prevent outbreaks, the surveillance unit can monitor the epidemiology of a particular disease so that the program can more accurately identify where the next cases might occur or the populations at highest risk. In addition, improving laboratory support for disease surveillance is essential for confirming causes of illness and early detection of outbreaks. Casebased investigation and laboratory confirmation provide the most precise 2 information about where action must be taken to achieve an elimination target. Monitoring populations at highest risk for a particular disease can help to predict future outbreaks and focus prevention activities in the areas where they are most needed.
THE UNITED STATES FEDERAL GOVERNMENT SHOULD PROVIDE ADDITIONAL FINANCIAL AND TECHNICAL RESOURCES AS NECESSARY TO ENSURE COMPREHENSIVE DISEASE SURVEILLANCE PROGRAM IN AFRICA SOUTH OF THE SAHARA
Contention One is Inherency
Disease surveillance systems in Africa are failing due to a severe lack of funds.
James Thuo Njugana, Master’s Degree in Biotechnology; Writer, Bonn International Center for Conversion, Biological and Chemical Weapons; Member, International Livestock Research Institute, worked on control of trypanosomosis and malaria; Writer, African Security Review [Peer Reviewed], 2005, Institute for Security Studies, African Security Review, Volume 14, Issue 1,
http://www.openj-gate.org/Articlelist.asp?Source=1&Journal_ID=103955bchang
Disease surveillance and control Infectious diseases can undermine the security of a country whether these diseases are deliberately inflicted by biological warfare or occur naturally. While the Biological and Toxins Weapons Convention (BTWC) prohibits the development and use of biological weapons, the defence against a natural or intentional epidemic is the same: a robust global public health surveillance system and the ability to respond efficiently and effectively to disease outbreaks. The state has an important role in combating the threat of deliberate disease because it has the moral duty to protect its citizenry. An effective way of countering the threat of deliberate disease is to establish and maintain disease surveillance and control programmes. Most of the publications on epidemics in eastern Africa indicate that very little disease surveillance is done at present.33 Where gains were made in control and eradication, they were later lost through neglect of control protocols such as vaccinations and control of livestock movements between endemic and non-endemic areas. There seems be unanimous agreement among observers that the main reason for the failure of surveillance and control systems is lack of funding. This is blamed on reduced funding for the responsible government organs and agencies owing to shrinking economies. National governments and other interested stakeholders will have to find the required funds, for if infectious diseases are not eradicated or at least maintained at minimum levels, an added threat will be their use as biological weapons, endangering people away from the endemic areas.34 Observers have expressed the view that disease surveillance should be intensified and coordinated beyond the divide of national boundaries. Surveillance programmes should be part of the public health management systems. The ideal situation requires setting up local and international surveillance/response teams. Teams endowed with the necessary techniques and resources should be put in place so that they can deal with epidemics when they occur. This will ensure that expertise in dealing with these diseases is available uniformly throughout the region.35 It is also important to register the groups/individuals engaged in these emergencies to minimise chances of hazardous materials being acquired by groups whose intent would be to cause disease outbreaks. Vaccination programmes have to be maintained because failure to do so may lead to a loss of the gains previously achieved in terms of disease control. Besides, for every case of sickness encountered, prevention is cheaper than cure. Some authors encourage joint veterinary and human disease surveillance as a way of cost cutting for zoonotic disease control and such a team can be schooled to monitor biological weapons as well (see the commentary by Dorothy Preslar in this issue of African Security Review).
Plan: The United States federal government should mandate the supply of all necessary resources to disease surveillance programs in sub-Saharan Africa.
Advantage One—Bioterrorism
Current African public health systems don’t take bioterrorism seriously; revitalizing disease surveillance systems is necessary to solve.
Chandre Gould, Writer, African Security Review [Peer Reviewed]; Network Coordinator, BioWeapons Prevention Project 2005, Institute for Security Studies, African Security Review, Volume 14, Issue 1,
http://www.openj-gate.org/Articlelist.asp?Source=1&Journal_ID=103955bchang
Do African countries share the perception that the threat of the use and development of biological weapons is increasing? Do African countries perceive themselves to be at risk from states or terrorist groups that may use biological weapons? What is the significance of the BTWC for Africa ? What more can be done to ensure that biological weapons are not used or developed on the African continent? What can non-governmental organisations, scientists, academics and government officials do to make Africa more secure? These are some of the questions that contributors to this volume have addressed. Several papers in this issue consider the perception of the relative insignificance of the threat of biological weapons use in Africa. This appears to be reflected in the high number of African states that have either not joined the BTWC, or that have signed but not ratified the convention. The authors of these papers present cogent arguments to support the contention that biological weapons control is an issue that should receive the attention of all African Union members. In his commentary the United Nations Under-Secretary-General for Disarmament Affairs, Nobuyasu Abe, notes that ‘increasing the number of African states parties to the BTWC would bring the convention closer to universality and send a strong message that the issue of biological weapons is truly a global concern and that Africa and the rest of the international community are united in grappling with it’. This view is echoed in the contribution by Dominique Loye and John Borrie, which provides details of the biotechnology, weapons and humanity appeal by the International Red Cross. Loye and Borrie also present a number of reasons that African countries should take the concern about biological weapons seriously. They argue that because African countries often lack sophisticated public health systems, a deliberate outbreak of disease could have catastrophic consequences. In his contribution, Dr Ben Steyn -considers the implications of UN Security Council Resolution 1540 and raises important -questions about how the resolution will be -interpreted and implemented. His article highlights the many difficulties, which are inherent to attempts to control biological agents. Through his analysis it becomes clear that the cost to states of implementing the resolution will be high and he indicates that unless key questions are answered about its implementation, the resolution may ‘create a false sense of security while the threat remains’. In his paper Thuo Njuguna draws attention to the effects that deliberate disease may have on the already overburdened public health system in East Africa and notes that the public health and disease surveillance systems necessary to deal with naturally occurring disease and deliberately caused disease are the same. In other words, strengthening public health systems and the ability to carry out disease surveillance is an important step in defending populations against the effect of deliberately caused disease. Dorothy Preslar’s commentary carries this argument further and assesses the potential benefits (and dangers) of increased transparency in reporting disease outbreaks. In her contribution Angela Woodward considers the type of legislation that states need to adopt to ensure they are in compliance with their obligations under the BTWC and UNSC Resolution 1540 and assesses the status of such legislation in African states. Her assessment reveals that there is still much that can be done in Africa. It is my hope that this publication will serve to initiate and inform increased debate and discussion about how Africans can work towards ensuring that biological weapons are never used or developed on this continent.
We’ll win probability and timeframe—Africa’s political climate means that a bioweapon attack is both imminent and inevitable. Terrorists already have access to weapons; they could attack at any time.
James Thuo Njugana, Master’s Degree in Biotechnology; Writer, Bonn International Center for Conversion, Biological and Chemical Weapons; Member, International Livestock Research Institute, worked on control of trypanosomosis and malaria; Writer, African Security Review [Peer Reviewed], 2005, Institute for Security Studies, African Security Review, Volume 14, Issue 1,
http://www.openj-gate.org/Articlelist.asp?Source=1&Journal_ID=103955bchang
Eastern Africa has seen many conflicts since World War II. Freedom wars, inter-state wars, civil wars and ethnic violence are either ongoing or are part of recent history.3 Economic hardship and inequalities, distrust of government and religious extremism are among the factors that have created a climate in which individuals or groups feel that any action they may take, however heinous, is justified in furthering their cause. This contributes to insecurity in the region and the world at large. Terror attacks in recent years, such as the bombing of the Oklahoma government building in the US (1995), the US embassy bombings in Kenya and Tanzania (1998),4 the attacks on the World Trade Center on 11 September 2001, and attacks in Morocco, Indonesia, Russia, Egypt and Spain, have led observers to realise the apparent danger of terrorist threats all over the world. Future terrorist attacks will -continue to involve bombs and firearms, but may also involve the use of biological weapons to cause disease.5 Major infectious diseases known to have potential in biological warfare are endemic in eastern Africa and often cases of emerging disease are reported from the region. This means that the disease-causing micro-organisms occur naturally in the region and are therefore accessible to those with sufficient knowledge to use to deliberately cause disease. This is an adequate reason to presume that eastern Africa, like other regions with similar conditions, faces a potential threat from BW. Outbreaks of Ebola fever (in Uganda and Sudan),6 Rift Valley fever (in Kenya and Somalia)7 and yellow fever (in Kenya)8 have been reported in recent years. The outbreaks of Ebola fever and Rift Valley fever in Uganda and Kenya respectively showed that the region has insufficient resources to deal with such epidemics. A successful deliberate disease attack would probably cripple the public health system. Both lethal and incapacitating agents could have an adverse impact on the civilian health care delivery system in a BW attack scenario. Potential manifestations include terror in the affected population and medical care personnel; an overwhelming number of casualties, placing demands on special medications; a need for personal protection in medical care settings and clinical laboratories; and problems with general handling.9 Biological agents with potential use as biological weapons The biological agents thought most likely to be used as biological weapons include B anthracis (anthrax), Francisella tularensis (tularemia), Yersinia pestis (plague), Variola virus (smallpox), agents of viral haemorrhagic fevers, and botulism toxin. Other likely agents include Brucella spp (brucellosis), Vibrio cholerae (cholera), Burkholderia pseudomallei (glanders), Coxiella burnetti (Q fever), agents of viral encephalitis, staphylococcal enterotoxin, ricin and mycotoxins (table 1).10 More than half of the organisms recognised as having a potential in biological warfare are endemic to the eastern Africa region. Elsewhere, the severe acute respiratory -syndrome (SARS) epidemic is the most recent reminder to the world of the challenges that emerging infectious diseases pose to health care systems, economies and overall security. While infectious diseases have traditionally been regarded as a medical issue, the threats posed by them in a rapidly changing global environment are no longer confined to the sphere of health risks. The disruption of business activities, travel and tourism (and hence economic growth and development) following the outbreak of SARS is among the serious potential repercussions that necessitated defining it and similar epidemics in broader, more strategic terms.11 Today the scale, speed and extent of the movement of people and goods are unprecedented. These movements, in turn, have shaped the appearance, spread and distribution of infectious diseases, not just in humans, but also in animals.12 The SARS case is instructive. With the movement of people in and out of China and the ease of international air travel, it was not surprising that SARS spread to more than 31 countries in every region of the world in less than six months.13 Indeed, in a -globalised world, no community can be entirely immune from emerging infectious diseases.14 While SARS appeared to have been contained, at least temporarily, by the end of 2003 and thus far has not become a global epidemic in the way that HIV/AIDS has,15 the economic losses associated with it may be felt for a long time in many countries. Similar cases of major economic damage and of the way the costs can be aggravated by initial lack of transparency are well documented for other infectious diseases, human and animal, originating in both wealthier and poorer countries.16 The HIV/AIDS pandemic continues and no clearly successful concerted international action exists to deal with it. A wide gap still exists between the threat posed by HIV/AIDS and coordinated, effective international action. Within a few years of its identification, HIV/AIDS had spread to every continent and every country. So far, 25 million people have died of AIDS, and about 3 million people a year continue to die from the disease. This massive loss of human resources involves the most economically productive group of the population, altering the economic and social structures of the countries that are most affected.17 It is widely acknowledged that openness has contributed directly to the relative success of Uganda in tackling AIDS.18 On the one hand, widespread coverage in the media has raised public awareness about the nature of the disease and avoiding infection. On the other hand, the willingness of those working in the health professions to share their knowledge and experience with journalists has encouraged informed reporting that, in turn, has strengthened the ability of individuals to take effective precautionary measures.19 This is in contrast to the approach taken by some governments on the same subject where information on the transmission of the disease (HIV/AIDS) to the public is confused or unclear.20 Unfortunately it follows that information on the control and prevention of the disease becomes unclear in the process. In 2000 the United Nations Security Council declared AIDS an international security threat, followed by similar political endorsements at the meetings in Okinawa and Genoa of the Group of Eight industrialised countries (G8).21 Despite these initiatives, however, AIDS, tuberculosis, malaria and other endemic diseases are perceived by many countries (if not most) as health or social problems, not as human -security threats. The lesson learned from the AIDS outbreak in Africa is that the media can be an important instrument of health policy. Countries whose governments provide the media with contradictory or incorrect information, as has happened with AIDS in some countries in Africa, or that conceal information, as occurred at the beginning of the SARS epidemic, risk losing the war against such diseases. Yet it remains common practice for many governments to consider that access to information by journalists, even in these areas, should be strictly controlled or managed.22 Openness to the media and the public is not simply a question of issuing timely and informative press releases.23 Management and containment of epidemics Ministries of health (MoHs) across Africa are mandated to deal with all health issues -including budgetary allocations to deal with infectious disease outbreaks. They are -responsible for -containing disease outbreaks wherever they occur in a country. Hospitals and care-giving institutions have a core function owing to their being in a special position to recognise an emerging outbreak of a given disease.24 Early detection of a biological agent attack or a natural outbreak depends on epidemiological warning networks and the individual clinical/laboratory expertise of medical personnel, because diagnostic procedures are the same for disease that is caused deliberately and for infections that occur naturally.25 During a crisis or outbreak an MoH may involve the services of its internal agencies or refer the matter to international organisations such as World Health Organisation (WHO) or non-governmental organisations (NGOs) for relevant action and to obtain support. Outbreaks of rare diseases are unpredictable and local health personnel may fail to recognise the early signs at the onset of a major epidemic, mostly because of lack of relevant skills. When this happens, people with contagious infections are allowed to move freely, putting others at risk. Corpses may be released for burial without a public health caution. When field workers in remote locations suspect a rare infectious disease, the referral/reference centres in the cities may not always have the facilities and reagents for some required tests. Samples then have to be sent abroad for testing to positively identify the infecting agents. This takes time and makes the management of the disease outbreak even more challenging as medical personnel have to deal blindly with unknown agents until identification details come from abroad. Consultation between operators is complicated by distance. Epidemic situations are always of concern to the members of public as well as the health professionals. The ministry of health is usually under pressure to do its best, a task made more difficult by the lack of resources in many -developing countries. Payment for health services by the users in some countries26 is a further impediment, as many cannot afford these costs. It is therefore in the interest of society that certain services should not be charged for, as this provides an incentive for people to seek treatment.27 The other impediment to effective public health management is the complete lack of infrastructure in some areas in developing countries. Sick people often die before they reach -hospitals. Poor communication means that outreach by public health educators is difficult and requires additional resources. Radio broadcasts could be of great help, but this service is not -developed either. Use of early warning systems such as weather forecasts and satellite imaging to predict and contain outbreaks should be part of the health management strategy. Heavy rains have been noted to be of key importance in disease outbreaks.28 Many epidemics are associated with extended heavy rains and include both vector-borne and water-borne diseases. The relationship between heavy rains and disease outbreaks could help to identify incidents of deliberately caused disease. The outbreak of major diseases under ordinary climatic conditions should be regarded with suspicion and infecting organisms studied further. Biotechnology trends in eastern Africa The extent of development of biotechnology and scientific research centres differs among the countries in eastern Africa. Most government and private research institutes are free from regulation at operational level and set and control their own research agendas. Institutes are trusted to ensure that only ethical research is conducted. In some countries there is a great deal of collaboration between national and international organisations, which facilitates transparency. In a vibrant biotechnology community, it is possible that unauthorised research can be conducted without the knowledge of the responsible authorities, for example the controversial HIV/AIDS research in humans done without the authority of the Kenya Medical and Licensing Board.29 Biomedical research should be managed to ensure that its applications are for peaceful purposes only.30 The core of future biological warfare threat will probably not consist of a large weapon stockpile, but will probably be the capacity to produce weapons (and their antidotes or phylaxis) on a large scale in a short time or in a crisis. Biotechnology may improve biological warfare capabilities through process and product improvement. This product improvement may involve modifications of pathogens through genetic engineering or through the creation of novel agents and vectors as well as through the development of new equipment for analysis and production. The process of improvement relates to the way agents are manufactured. Optimisation of procedure could lead to production of larger batches within very limited time or the use of small, less conspicuous equipment that is easier to hide in legitimate installations and activities. Genetically modifying existing pathogens may make them more virulent and resistant to drugs and render these agents resistant to environmental stress such as ultra-violet radiation and meteorological conditions after their release to the environment. It is therefore important to have controls in place that will make it less likely for biotechnology to be used to develop or improve biological weapons.31 The level of deliberate disease threat in -eastern Africa A deliberate disease threat assessment is needed to reduce the uncertainty that currently permeates debate over biological terrorism. Undertaking such a threat assessment is important in the current environment where the public feels insecure and limited resources are available to improve the situation. An analysis of the threat of use of biological weapons would include identifying which groups or individuals might pose a threat, which agents might be used, how
[CONTINUED]
an attack might be carried out, what motivates groups or individuals to use such weapons and which areas would be targeted. Answers to these questions will lead to the development of a number of possible scenarios. The level of threat is a reflection of the will to use these agents, and not just a technical issue of how to use them. All countries in eastern Africa face some level of threat because of the conflicts and insecurity in the region as well as the easy access to infectious materials. The impact of the use of biological weapons would be most direct on clinical -microbiologists. If a terrorist attack with a biological agent were to occur, medical microbiology laboratories would be instrumental in helping to detect and identify the agent and in alerting authorities. Referral centres should have all necessary resources to support the field laboratories. Although Bacillus anthracis has received a great deal of publicity as a potential biological weapon, other organisms should not be ignored. Terrorist activities Terrorist groups exist to promote religious, ethnic, political (ideological) or economic causes. Acts of biological terrorism could therefore have political, religious, ideological or criminal motives and could conceivably be planned by groups or a single individual or be part of state-sponsored terrorist activities The activities leading to the 1998 American embassy bombings in Kenya and Tanzania were well coordinated and planned. This trend has continued with most recent attacks across the world. Various attacks are timed to take place simultaneously and on multiple targets. This indicates that terrorist groups make extensive plans for these activities. It is now known that the suspected perpetrators can be citizens of one or different countries, which demonstrates the capacity of these groups to successfully recruit members and execute plans undetected by law enforcement agencies. This was true of the events of 11 September 2001 in the United States. When compared to other weapons, the acquisition, storage and transportation of -biological weapons could be considerably easier. Competent undergraduate students could readily master viral, bacterial culture methods and simple genetic engineering. It is possible that a group or individuals with appropriate training could produce lethal weapons in adequate amounts and then disseminate them in a manner that would result in thousands of casualties and widespread panic. Outbreaks of infectious diseases are a common occurrence in eastern Africa and the region suffers from insecurity owing to countless conflicts. This makes the threat of the use of biological weapons in this region something that has to be considered by the relevant -government departments. In addition, the -distinction between national and global threats is artificial, as infectious agents do not observe the divide. Adequate public health surveillance and response are solutions to preparing for biological warfare events. Only long-term planning and funding can sustain such a global undertaking, which has to be internationally financed and managed. Infectious diseases with no known prophylactic remedies will continue to infect travellers and local people and remain a possible biological weapon.32
A bioterror attack would cause human extinction—it outweighs nuclear war.
Richard Ochs, Member, Depleted Uranium Task Force, Military Toxics Project; former President, Aberdeen Proving Ground Superfund Citizens Coalition; Member, Chemical Weapons Working Group, Freelance Writer, 6/9/02, Free From Terror, “Biological Weapons Must Be Abolished Immediately,” http://www.freefromterror.net/other_articles/abolish.html
Of all the weapons of mass destruction, the genetically engineered biological weapons, many without a known cure or vaccine, are an extreme danger to the continued survival of life on earth. Any perceived military value or deterrence pales in comparison to the great risk these weapons pose just sitting in vials in laboratories. While a "nuclear winter," resulting from a massive exchange of nuclear weapons, could also kill off most of life on earth and severely compromise the health of future generations, they are easier to control. Biological weapons, on the other hand, can get out of control very easily, as the recent anthrax attacks have demonstrated. There is no way to guarantee the security of these doomsday weapons because very tiny amounts can be stolen or accidentally released and then grow or be grown to horrendous proportions. The Black Death of the Middle Ages would be small in comparison to the potential damage bioweapons could cause. Abolition of chemical weapons is less of a priority because, while they can also kill millions of people outright, their persistence in the environment would be less than nuclear or biological agents or more localized. Hence, chemical weapons would have a lesser effect on future generations of innocent people and the natural environment. Like the Holocaust, once a localized chemical extermination is over, it is over. With nuclear and biological weapons, the killing will probably never end. Radioactive elements last tens of thousands of years and will keep causing cancers virtually forever. Potentially worse than that, bio-engineered agents by the hundreds with no known cure could wreck even greater calamity on the human race than could persistent radiation. AIDS and ebola viruses are just a small example of recently emerging plagues with no known cure or vaccine. Can we imagine hundreds of such plagues? HUMAN EXTINCTION IS NOW POSSIBLE. Ironically, the Bush administration has just changed the U.S. nuclear doctrine to allow nuclear retaliation against threats upon allies by conventional weapons. The past doctrine allowed such use only as a last resort when our nation's survival was at stake. Will the new policy also allow easier use of US bioweapons? How slippery is this slope? Against this tendency can be posed a rational alternative policy. To preclude possibilities of human extinction, "patriotism" needs to be redefined to make humanity's survival primary and absolute. Even if we lose our cherished freedom, our sovereignty, our government or our Constitution, where there is life, there is hope. What good is anything else if humanity is extinguished? This concept should be promoted to the center of national debate.. For example, for sake of argument, suppose the ancient Israelites developed defensive bioweapons of mass destruction when they were enslaved by Egypt. Then suppose these weapons were released by design or accident and wiped everybody out? As bad as slavery is, extinction is worse. Our generation, our century, our epoch needs to take the long view. We truly hold in our hands the precious gift of all future life. Empires may come and go, but who are the honored custodians of life on earth? Temporal politicians? Corporate competitors? Strategic brinksmen? Military gamers? Inflated egos dripping with testosterone? How can any sane person believe that national sovereignty is more important than survival of the species? Now that extinction is possible, our slogan should be "Where there is life, there is hope." No government, no economic system, no national pride, no religion, no political system can be placed above human survival. The egos of leaders must not blind us. The adrenaline and vengeance of a fight must not blind us. The game is over. If patriotism would extinguish humanity, then patriotism is the highest of all crimes.
Disease surveillance is the most critical internal link to fighting bioterror—it would provide early warnings and other information necessary to solve.
Joseph P. Dudley, Ph.D., Biologist; Wildlife Ecologist; former Diplomacy Fellow, American Association for the Advancement of Science; former U.S. Peace Corps volunteer, 11/04, BioScience, Volume 54, Issue 11, “Global Zoonotic Disease Surveillance: An Emerging Public Health and Biosecurity Imperative,” http://www.bioone.org/perlserv/?request=get-document&issn=0006-3568&volume=054&issue=11&page=0982bchang
In addition to the threats presented by emerging and rapidly evolving natural disease organisms are those posed by laboratory cultures of genetically modified, weaponized strains of disease pathogens created and developed for use as biological weapons against humans, domesticated livestock, or crops. The anthrax “letter bomb” attacks of September–October 2001 demonstrated the critical need for recognizing that zoonotic disease surveillance and information systems are important elements of our public health and homeland security infrastructure, the nation's first line of defense and response against terrorist attacks involving bioweapon diseases (Dudley 2003). The deliberate or accidental release of weaponized disease pathogens could have devastating direct effects on biodiversity and agricultural productivity—and possibly even more devastating indirect effects on wildlife, including some endangered species, should these become targeted for extirpation because they could become reservoirs or vectors of bioweapon disease pathogens. There is currently no single entity within the government with “command and control” responsibility and regulatory authority for managing the growing nationwide health problems associated with diseases that are passed between wildlife, domesticated animals, and humans (Benjamin et al. 2003). Federal agencies in the United States that have a role in the international monitoring of zoonotic and animal diseases of public health significance, or regulatory authority over potential means through which such diseases could be introduced from overseas, include the US Department of Agriculture's Animal and Plant Health Inspection Services, the Centers for Disease Control and Prevention, the US Public Health Service, the US Fish and Wildlife Service, the US Geological Survey, the Department of Homeland Security, the Department of the Army, and the Department of Defense. Each of these federal agencies has at least two, and in some instances four or more, different component organizations involved in the prevention, monitoring, surveillance, evaluation, identification, or control of zoonotic pathogens or foreign animal diseases. International organizations, multilateral organizations, nongovernmental organizations, and national organizations involved in zoonotic disease surveillance monitoring efforts include the World Health Organization, the United Nations Food and Agriculture Organization, the World Organisation for Animal Health (formerly known as the Office International Epizooties, or OIE), the IUCN–World Conservation Union, and the newly chartered European Centre for Disease Prevention and Control. Although there is considerable cooperation and collaboration among individuals within the infectious disease surveillance and response communities, the degree of formal organizational collaboration and coordination is frequently limited. None of these entities has the mandate or mechanisms to actively seek out and disseminate information on emerging wildlife diseases and zoonoses to all interested public and private sector organizations and agencies. Those government agencies and multilateral organizations that do perform such functions typically operate under institutional or diplomatic constraints that do not permit the dissemination of critically important “unconfirmed” information on disease outbreaks. Yet such information could constitute an early warning system for diseases such as avian influenza or citrus sudden-death virus, for which the confirmation of outbreaks through official channels may be suppressed. Governments may, for example, seek to avoid externally imposed bans on the export of economically important animal or plant products, as happened with the pandemic outbreaks of avian influenza in Asia during 2003 and 2004. Decisionmakers and governments must be encouraged to achieve greater levels of effectiveness in the surveillance and monitoring of infectious diseases in humans, wildlife, crops, and livestock. Information technology tools and methods now available can enhance communication and coordination among all stakeholders in the wildlife health, agriculture, and public heath sectors—including federal and state government agencies, multilateral organizations, the public health community, nongovernmental organizations, private sector corporations, and scientific and professional organizations. For such efforts to be effective, however, clear policy mandates must be in place to encourage and ensure the rapid worldwide sharing and dissemination of information on infectious disease outbreaks.
Advantage Two—Avian Flu
A human outbreak is extremely probable in Africa—lack of surveillance means it’ll slip under the radar until it’s too late to contain.
WHO, World Health Organization, 2005, World Health Organization, Regional Office for Africa,
“Influenza Pandemic Risk Assessment and Preparedness in Africa,” http://www.afro.who.int/csr/epr/avian_flu/afr_avian_flu_31_10_05.pdfbchang
Risk assessment for Africa Outbreaks in poultry: Significance for human health The arrival of highly pathogenic H5N1 avian influenza on the African continent would be of great concern for human as well as animal health. Though the densities of human and poultry populations are generally lower in Africa than in south-east Asia, the poultry production systems have many similarities which could create multiple opportunities for human exposure, if outbreaks occur in African poultry. In Africa, many households keep backyard flocks which often mingle freely with wild birds. Most such flocks scavenge for food, often entering households or sharing outdoor areas where children play. With few exceptions, notably in large commercial farms, surveillance for avian disease is non-existent. Nutrition of the birds is poor and high mortality is common, increasing the likelihood that outbreaks of H5N1 will be missed. Few governments are in a position to offer support for disease control or compensation for lost birds, thus further discouraging early and open reporting. As experience in Asia has shown, late detection of outbreaks increases the likelihood that the virus will become endemic. Deaths of large numbers of poultry, whether due to disease or culling for control purposes, would deprive already impoverished populations of an important source of dietary protein. Human cases In Africa, the risk of human infection from an avian H5N1 virus can be expected to be similar to that seen in Asia. To date, the majority of human cases in Asia have been linked to close contact with infected domestic birds, with especially high risks thought to occur during home slaughter, defeathering, butchering and preparation for cooking. Consumption of inadequately cooked poultry and poultry products (including eggs and blood) is an additional risk. African households, especially in rural areas, traditionally 4 slaughter and consume birds when signs of illness appear in backyard flocks. As in Asia, such practices could prove difficult to change. The occurrence of human cases, even sporadic, would create enormous new challenges for health systems and services that are already fragile and overburdened. Early detection of human cases is unlikely. Surveillance systems are weak and unlikely to pick up cases of a disease with symptoms similar to those of common illnesses. Health service, human and financial resources have been overwhelmed by the demands of AIDS, tuberculosis and malaria. Laboratory confirmation of human H5N1 infections requires technology, finances and trained personnel. Management of H5N1 patients is very demanding. Infection control in most hospitals is difficult to introduce and sustain. Sporadic cases of H5N1 infection and the frequent reluctance of residents to comply with recommended reporting and isolation measures during outbreaks of severe disease could push fragile health systems close to the brink of collapse. Surveillance systems are not sufficiently sensitive to clusters of human cases, although they constitute a critical early warning signal that the virus is improving its transmissibility. Africa has some well-equipped laboratories, but these might rapidly prove inadequate should large numbers of samples need to be tested rapidly.
Spillover is guaranteed—due to globalization, avian flu will quickly spread out of Africa to the rest of the world if not contained.
Joseph P. Dudley, Ph.D., Biologist; Wildlife Ecologist; former Diplomacy Fellow, American Association for the Advancement of Science; former U.S. Peace Corps volunteer, 11/04, BioScience, Volume 54, Issue 11, “Global Zoonotic Disease Surveillance: An Emerging Public Health and Biosecurity Imperative,” http://www.bioone.org/perlserv/?request=get-document&issn=0006-3568&volume=054&issue=11&page=0982bchang
The proliferation of disease pathogens that can infect humans, livestock, wildlife, and other animals increasingly threatens biodiversity and environmental security, and has collateral impacts on human health and international commerce. Globalization means that physical distance from outbreaks of zoonotic diseases—even distances spanning half the globe—can no longer be considered a safeguard against infection from those diseases. The unexpected resurgence in human deaths from H5N1 avian influenza in Vietnam and Thailand during August and September 2004 and the first evidence of direct human-to-human transmission of this potentially deadly zoonotic disease clearly demonstrate the need for international cooperation and collaboration in the identification, monitoring, and control of zoonotic diseases around the globe. The SARS (severe acute respiratory syndrome) virus, H5N1 avian influenza virus, Nipah virus, and Ebola virus are only the most widely publicized examples of a growing list of emerging infectious diseases transmitted between wild animals and human beings, often with domesticated livestock or human commensals such as rats and pigeons involved in the chain of infection and transmission (Guan et al. 2003). The globalization of industrial livestock production and the rapidly expanding international trade in animals and animal products from wild and domesticated species are fostering the emergence and global proliferation of new zoonotic diseases with the ability to pass between and among humans, wildlife, and domesticated animals. Recent increases in the emergence and proliferation of pathogens are being driven by human transformations of natural landscapes for agriculture and livestock production, human selection through indiscriminate or inappropriate uses of antibiotics, deliberate and accidental introductions of exotic invasive alien species, and a $6 billion global trade in exotic animals and plants. Rapidly expanding and increasingly concentrated populations of humans and livestock are fostering the emergence of virulent zoonotic pathogens that may cause fatal disease in humans and animals. Diseases like tuberculosis and polio, which were once thought susceptible to global eradication, are reclaiming lost ground, while viral diseases of humans and animals are evolving new strains that go undetected and thus thwart regional and global vaccination programs. The ancient scourges of anthrax and plague are proliferating once again in areas of Africa and Asia beset by drought, poverty, war, and civil strife. The history of rinderpest in Africa, where the devastating loss of livestock and game animals caused widespread famine, shows that outbreaks of disease in animals may prove just as lethal for indigenous peoples and pastoral communities as human diseases like smallpox or pneumonic plague. The 2003–2004 avian influenza pandemic in Asia was unprecedented in its severity and geographic scope, with exceptionally high virulence in avian as well as human populations. Death rates among confirmed human victims of the H5N1 avian influenza virus in Vietnam and Thailand (> 70 percent mortality) are comparable to those reported among human cases of the Ebola virus in central Africa and Nipah virus in Bangladesh. Emerging and endemic zoonotic diseases are demonstrably no longer a safely distant, third-world health phenomenon. The past several years have seen an astounding resurgence of zoonotic diseases as public health threats in the United States, including Emergence of tick-borne Lyme disease as a significant public health problem in the suburban landscapes of the eastern United States The appearance of West Nile virus in New York City and its rapid spread throughout the temperate regions of North America and southward into the Caribbean and Central America, with significant impacts on populations of wild birds and mammals, horses, and humans
The introduction of monkeypox, a formerly obscure zoonotic disease from the rain forests of central Africa, into the United States through the exotic pet trade .
Disease surveillance is necessary to prevent avian flu from secretly spreading without detection, which would make it uncontainable.
US State Department, 3/6/06, “United States, Partners Build Global Disease Surveillance” http://usinfo.state.gov/xarchives/display.html?p=washfile-english&y=2006&m=March&x=20060302154057cmretrop0.1840326) [Ram]
The United States’ efforts to protect its citizens from deadly pandemic influenza will be only as successful as its efforts to protect citizens of other nations from the avian influenza. The bird flu virus H5N1 has now appeared in birds some 30 nations. “The best defense of the United States is what we do internationally,” said Kent Hill, assistant administrator for global health at the U.S. Agency for International Development (USAID) in testimony before a U.S. House Appropriations subcommittee March 2. Explaining the potential for avian influenza to escalate rapidly into a lethal, fast-moving human disease, U.S. Centers for Disease Control and Prevention Director Julie Gerberding said, “We are only as strong as our weakest link.” The warning made an impression on members of the Foreign Operations, Export Financing and Related Programs Subcommittee. “That’s disturbing,” said Representative Don Sherwood, a Pennsylvania Republican. “There are places in the world where [pandemic influenza] could get a pretty good head start on us and we wouldn’t know it.” The United States, working in partnership with other nations, has undertaken a variety of initiatives to help improve the capability for disease surveillance and detection in other nations in a shared strategy that has emerged from a series of international meetings over the last six months.
Every day the risk of mutation increases. Early detection through surveillance is critical to solve the disease.
Charlene Porter, Washington File Staff Writer, 3/2/06,
http://usinfo.state.gov/af/Archive/2006/Mar/02-409618.html
The dangerous H5N1 avian influenza virus has become endemic in birds in Asia and has been moving steadily westward. It also can infect humans, and the World Health Organization has documented 174 cases over the last two years, resulting in 94 deaths. Direct contact between humans and ailing poultry has been determined to be the cause of all but one of those cases. Health officials warn that the virus could mutate to become easily transmissible to and among humans. That might lead to pandemic influenza with the potential to cause millions of deaths and widespread social and economic turmoil. As more and more birds are exposed in more and more places, the opportunities for that mutation to occur increase. The earliest possible detection and elimination of infection in birds are considered the best strategy for pandemic prevention. Since the appearance of H5N1 in Nigeria in February, Hill said USAID has worked to recruit and train local organizations that have helped wage the battle against polio now to become involved in bird flu surveillance. Unusual fatalities among birds were spotted in Nigeria in January, Hill said, but initially were misdiagnosed and attributed to another less serious disease. The anecdote demonstrates that capable surveillance is a problem, and the international assistance effort is just beginning a long process to upgrade it, Hill said.In Cambodia, Gerberding said, CDC is using a similar strategy to solicit the help of ordinary people. Every village now has a veterinarian’s aide who has been trained to spot sick birds; each is equipped with a cell phone to call regional or national health authorities if signs of disease start appearing in backyard poultry. Members of the appropriations subcommittee, who will be influential in future spending decisions on bird flu overseas assistance, expressed concern about whether current U.S. plans will do enough to help build disease surveillance and containment. About $6.5 million now is earmarked for assistance to Africa, and some members questioned whether that amount will be adequate now that outbreaks have been detected in animals in both Nigeria and Niger. Leaders of U.S. government health agencies acknowledged that review of the plan will be an ongoing task, requiring constant vigilance.
Once mutated, avian flu would kill billions and wreck the global economy.
Chandra ’04 (Mr. Satish Chandra is the Deputy National Security Advisor of India – Center for Strategic Decision Research – Global Security: A broader Concept for the 21st Century -- May 7th)
Indirect threats to global security arise not from issues customarily associated with security, such as war, regional conflict, civil strife, proliferation of nuclear weapons, and terrorism, but from issues traditionally not considered to significantly impact security, such as climate change, disease, poverty, and economic inequities. The latter threats could perhaps more appropriately be termed nonconventional rather than indirect, since failure to address them can have as disastrous an impact on our existence and well-being as the failure to address more conventional threats. I will highlight the grave dangers posed by two of these threats, climate change and flu pandemics, and outline briefly what we can and need to do. Because both of these dangers are able to inflict on us, during the next few years, devastation of an order hitherto never visited on mankind, I would like to paint two entirely plausible hypothetical scenarios to bring home the gravity of the situation. It is 2015. Despite much debate and warning, the world has done little to address the buildup of greenhouse gases and the consequent acceleration of global warming, which is accompanied by increasingly unpredictable world weather patterns. Extreme heat, storms, and droughts have created havoc for farmers. Mega-droughts are affecting major granaries. The world’s agricultural production and freshwater resources are seriously stretched, reducing the planet’s carrying capacity. Deaths from famine and drought are in the hundreds of thousands. Violent and frequent storms are lashing Western Europe, leading to the abandonment of low-lying cities such as The Hague. Rising sea levels have made countries such as Bangladesh nearly uninhabitable, resulting in mass migration. This scenario, as frightening as it is, pales in comparison with what could overtake us by 2007 if the highly pathogenic form of bird flu “H5N1” becomes transmittable human to human; all it would take for this to happen is a simple gene shift in the bird flu virus, which could happen any day. In a globalized world linked by rapid air travel, the disease would spread like a raging forest fire. If it did, it would overwhelm our public health system, cripple our economies, and wipe out a billion people within the space of a few months—a 60 percent mortality rate is estimated.
We must act now—avian flu is already on the move in Africa—implementing surveillance immediately is the only way to solve.
US State Department, 6/7/07, “U.S. Fights Pandemic Influenza in Sub-Saharan African Nations” http://usinfo.state.gov/xarchives/display.html?p=texttrans-english&y=2007&m=June&x=20070607162958eaifas0.852688) [Ram]
Since sub-Saharan Africa’s first reported outbreak of highly pathogenic avian influenza (HPAI) H5N1 in Nigeria in February 2006, the disease has spread to birds in Burkina Faso, Cameroon, Côte d’Ivoire, Djibouti, Ghana, Niger and Sudan. As of May 2007, the World Health Organization (WHO) had confirmed one human fatality in Nigeria and one non-fatal human case in Djibouti. The deaths or infections of hundreds of thousands of birds are causing social and economic disruption with implications for African food supplies and incomes, and pose serious risks to human health through exposure to infected birds. The United States combats HPAI H5N1 in sub-Saharan African nations by working with governments and regional entities, and with international organizations such as the WHO, the Food and Agriculture Organization (FAO), UNICEF and the World Organization for Animal Health (OIE). Through the International Partnership on Avian and Pandemic Influenza, the United States works to elevate the issue on national agendas – and to coordinate efforts between affected nations in sub-Saharan Africa and donors. To assist in responding to HPAI H5N1 outbreaks and in preparing for a possible human pandemic, the United States is supporting efforts in much of sub-Saharan Africa through bilateral and regional programs.
Economic collapse culminates in a US-China nuclear war.
Mead 04 – Senior Fellow at Council on Foreign Relations
[Walter Russell, “America's STICKY Power,” Foreign Policy, Mar/Apr, Proquest]
Similarly, in the last 60 years, as foreigners have acquired a greater value in the United States-government and private bonds, direct and portfolio private investments-more and more of them have acquired an interest in maintaining the strength of the U.S.-led system. A collapse of the U.S. economy and the ruin of the dollar would do more than dent the prosperity of the United States. Without their best customer, countries including China and Japan would fall into depressions. The financial strength of every country would be severely shaken should the United States collapse. Under those circumstances, debt becomes a strength, not a weakness, and other countries fear to break with the United States because they need its market and own its securities. Of course, pressed too far, a large national debt can turn from a source of strength to a crippling liability, and the United States must continue to justify other countries' faith by maintaining its long-term record of meeting its financial obligations. But, like Samson in the temple of the Philistines, a collapsing U.S. economy would inflict enormous, unacceptable damage on the rest of the world. That is sticky power with a vengeance. The United States' global economic might is therefore not simply, to use Nye's formulations, hard power that compels others or soft power that attracts the rest of the world. Certainly, the U.S. economic system provides the United States with the prosperity needed to underwrite its security strategy, but it also encourages other countries to accept U.S. leadership. U.S. economic might is sticky power. How will sticky power help the United States address today's challenges? One pressing need is to ensure that Iraq's econome reconstruction integrates the nation more firmly in the global economy. Countries with open economies develop powerful trade-oriented businesses; the leaders of these businesses can promote economic policies that respect property rights, democracy, and the rule of law. Such leaders also lobby governments to avoid the isolation that characterized Iraq and Libya under economic sanctions. And looking beyond Iraq, the allure of access to Western capital and global markets is one of the few forces protecting the rule of law from even further erosion in Russia. China's rise to global prominence will offer a key test case for sticky power. As China develops economically, it should gain wealth that could support a military rivaling that of the United States; China is also gaining political influence in the world. Some analysts in both China and the United States believe that the laws of history mean that Chinese power will someday clash with the reigning U.S. power. Sticky power offers a way out. China benefits from participating in the U.S. economic system and integrating itself into the global economy. Between 1970 and 2003, China's gross domestic product grew from an estimated $106 billion to more than $1.3 trillion. By 2003, an estimated $450 billion of foreign money had flowed into the Chinese economy. Moreover, China is becoming increasingly dependent on both imports and exports to keep its economy (and its military machine) going. Hostilities between the United States and China would cripple China's industry, and cut off supplies of oil and other key commodities. Sticky power works both ways, though. If China cannot afford war with the United States, the United States will have an increasingly hard time breaking off commercial relations with China. In an era of weapons of mass destruction, this mutual dependence is probably good for both sides. Sticky power did not prevent World War I, but economic interdependence runs deeper now; as a result, the "inevitable" U.S.-Chinese conflict is less likely to occur.
[Insert Strait Times 2K]
Disease surveillance would allow us to track and contain the avian flu.
Declan Butler, Chevalier, France's National Order of Merit; European Correspondent and Writer, Nature Magazine; Ph.D., Biology, Queen’s University, 3/1/06, Nature, “Disease Surveillance Needs a Revolution,” http://www.nature.com/news/2006/060227/full/440006a.htmleveryone
With avian flu spreading around the world at a frightening rate, scientists are welcoming an international proposal for state-of-the-art labs to monitor emerging diseases in developing countries. But they add that the bird-flu crisis has exposed glaring deficiencies that demand a radical rethink of the world's veterinary and disease-surveillance systems. Avian flu is now endemic across large parts of Asia, and in the past few weeks has exploded across Europe and into Africa. "H5N1 has focused the spotlight of the world on disease surveillance, and it's showing up all the pimples and warts," says Bill Davenhall, who develops health mapping schemes for countries and is head of health at ESRI, a geographic information systems company in Redlands, California. Developing countries, in particular, lack decent human-disease surveillance, and animal monitoring is often virtually nonexistent, with few basic laboratory and epidemiological resources available. "On the ground in Indonesia, there is no systematic programme at all," says Peter Roeder, a field consultant with the United Nations' Food and Agriculture Organization (FAO). "It's just a bloody mess." Global danger It is a problem that the developed world cannot ignore, because a disease that emerges in Bangkok or Jakarta could ultimately trigger a global disaster. So researchers at the US Department of Defense have suggested setting up a network of high-tech labs in developing countries to monitor cases of infectious disease (see page 25). The labs would be modelled on the US network of infectious-disease labs, such as the naval research unit NAMRU-2 in Jakarta. But they would be funded by the international community to avoid the local distrust that has often hampered labs run by the US military. Such a network could vastly speed up and improve the diagnosis of viruses such as H5N1 when outbreaks occur, says Roeder. He points out that misdiagnosis of H5N1 as Newcastle disease in recent outbreaks in Nigeria and India led to long delays in control measures. Mark Savey, an epidemiologist who heads animal health at France's food-safety agency, also welcomes the proposal, but cautions against the "mirage of technology" in surveillance. "You don't need satellites, PCR and geographic information systems to fight outbreaks," he says. The labs' top priority should be building large teams of local staff, who are familiar with the region and its practices, he argues. "If you do not have that, then surveillance will stay in the Middle Ages." Savey recalls his trip to Russia last summer as part of a European team investigating outbreaks of avian flu. "You have a paper Michelin map; you have people who speak the language; you put red circles on outbreaks; and you use a pen and paper to compare them with things like the dates of market openings, and with how outbreaks line up with railways." Such local knowledge is crucial to interpreting data, he says. "If you don't know what the Trans-Siberian Express is like, with people cooped up for days, exchanging chickens and eggs at every stop, you would never guess that it was the Trans-Siberian that mainly spread avian flu across Russia." Roeder agrees that the focus must be local. "No amount of setting international guidelines and publishing global action plans is going to help when you have an organization within the country that doesn't know what to do," he says. Back to basics But many feel that alongside setting up local centres, epidemiology needs a fundamental overhaul. Even in developed countries, the field has been chronically underfunded, says Antoine Flahault, director of Sentinelles, France's national disease surveillance network. He adds that he is jealous of the multimillion-dollar satellites that climate scientists enjoy and the powerful accelerators being built for physicists. In comparison, epidemiologists "are still in the nineteenth century", he says. Flahault points out that his own national flu-monitoring system relies on a few hundred volunteer doctors submitting patient data to an online database. From these data, Flahault's team tries to build up a picture of disease across the country, spotting outbreaks and predicting when the year's flu season will hit. The 122-city programme run by the US Centers for Disease Control and Prevention is the only one in the world where disease reports are made in real time, Flahault points out. And such lack of data prevents the field from developing sophisticated models of communicable disease. "It's as if we were trying to study the weather, but collected data only when there was a heatwave or storm," he says. Ward Hagemeijer, the bird-flu programme manager at Wetlands International in Wageningen, the Netherlands, also complains of the general lack of resources. He has been on recent missions to sample H5N1 in affected countries, but says he has been unable to get his African samples sequenced because certified labs have been too busy analysing samples from European outbreaks.
Advantage Three—Genocide
Disease surveillance is necessary to predict and prevent genocide before it occurs—the work involved in the surveillance of diseases can be easily applied to prevent violence.
David P. Eisenman, assistant professor for the Division of General Internal Medicine and Health Services Research at the UCLA School of medicine, 2002, “Genocide” Encyclopedia of public health, http://health.enotes.com/public-health-encyclopedia/genocide [Nathan]
The precursors, processes, and consequences of genocide are increasingly being understood, and public health contributes to this understanding in a distinct manner from other disciplines, such as the law profession and the human rights field. Specifically, public health brings to the study of genocide the unique tools of epidemiology, which is the study of the distribution of disease and the factors associated with a disease within a population. Since public health views a specific population or group of human beings in an ecological model that includes the institutions (e.g., paramilitary organizations) and the objects (e.g., weapons of genocide) they have created, it is only natural that public health views genocide in this manner, too. Thus, public health professionals can examine genocide as a disease, along with social and behavioral factors that correlate with the disease, and may even cause it. The work that public health professionals do to examine, prevent, and mitigate genocide can be understood in terms of the three traditional core functions of public health: assessment, policy development, and assurance of services. Assessments can be performed through data collection and analysis intended to identify, document, and notify the public about potential or ongoing genocide. Here the public health principles of disease and injury surveillance can be applied to violence against a population, and the traditional tools of public health—such as case reports and surveillance studies—are well suited to this function. A genocide may have early warning signs that public health professionals can detect, such as escalating violence, increased refugee flows out of a country, and increasing systematic discrimination. In those cases where a war strategy targets the health of an entire group of people, public health professionals are best able to recognize the nature of the genocide.
Moreover, this system allows the prediction of refugee migrations, which is a critical internal link into solving massive manifestations of violence, including civil wars and genocide.
Jeff Grabmeier assistant director of research communications at Ohio State University, 9/29/98, “Warning Systems may help predict potential refugee crises”, http://researchnews.osu.edu/archive/refugee.htm [Nathan]
COLUMBUS, Ohio -- When natural disasters like hurricanes or floods threaten, experts can usually give people early warnings so they have time to prepare. Now social scientists are working to develop similar early warning systems that can forecast political and social disasters that are sometimes deadlier and more costly than natural calamities. In one new model, researchers have identified some of the important factors that may predict refugee migrations within a country or from one country to another. “Refugee migrations are not random occurrences -- they stem from political and social problems that can be predicted,” said Craig Jenkins, a professor of sociology and a researcher at Ohio State University’s Mershon Center for International Security. “We think it is as important to predict refugee migrations as it is to predict hurricanes.” Jenkins developed the model with Susanne Schmeidl from the Swiss Peace Foundation in Bern, Switzerland. The model will be published this year as a chapter in the book Preventive Measures: Building Risk Assessment and Crisis Early Warning Systems (John Davies and Ted Gurr, editors; Rowman and Littlefield, 1998). Using 1971-1995 data from the United Nations and other sources, Jenkins and Schmeidl identified both long-term, root causes of refugee migrations as well as the more immediate factors that sparked the crises. They found that the major root causes included weak governments, long-standing ethnic antagonisms and inequality, and poverty linked to economic dependence on other countries. Large migrations were often immediately preceded by some type of generalized violence: civil wars, genocide or politicide in the affected countries, or foreign military interventions. One unexpected finding was that population growth and density in a country was not related to refugee crises. “Many policymakers have argued that population pressure is one of the central sources of humanitarian crises, but we didn’t find that,” Jenkins said. “It may be a general symptom of less-developed countries, but not of crisis-prone countries in particular.” Although most of the factors associated with refugee problems are not surprising, Jenkins said there has never been a systematic effort to collect all the relevant data and use it to forecast -- and possibly prevent -- social or political disasters. The United Nations and various humanitarian agencies currently do international monitoring to predict when and where disasters will occur, Jenkins said. But they use the information mostly as a crisis management tool, to plan for dealing with the disasters. “We hope to develop warning systems that are more complete and accurate so that we can identify potential trouble spots long before they erupt and possibly prevent problems from occurring,” he said. “Of course, compared to forecasting a hurricane, there is a much larger margin of error when you’re trying to predict forced migrations. But we’re taking small steps that may eventually help us prevent or at least mitigate some of these social and political disasters.” There is a huge need to predict and prevent refugee problems, according to Jenkins. In 1970, there were about 14 million people worldwide who were displaced from their homes, either to other countries or within their own. By 1990, that number had skyrocketed to 39 million. The number dropped slightly between 1990 and 1995. Jenkins said he is now working to improve the model in order to make it more accurate. One avenue he is exploring is identifying the factors that lead to “political meltdown” in a country. Political instability and violence in a country often lead to refugee problems. “The need for humanitarian early warning is great,” he said. “Once political violence has broken out, it’s usually too late to de-escalate the conflict. We need to develop better information on the root causes, especially inequalities and ethnic problems. And we also need better information about conflict escalation and the factors that immediately precede refugee migrations.”
We as intellectuals must speak out in public forums against genocide. Continual failure to deal with genocide crushes the human spirit and makes multiple scenarios for extinction inevitable. Our ethic is key to solve all suffering.
Ketels ’96 Associate Professor of English at Temple Universitybchang
Even though, as Americans, we have not experienced “by fire, hunger and the sword”, the terrible disasters in war overtaking other human beings on their home ground, we know the consequences of human hospitality to evil. We know about human perfidy: the chasm that separates proclaiming virtue from acting decently. Even those of us trained to linguistic skepticism and the relativity of moral judgment can grasp the verity in the stark warning, “If something exists in one place, it will exist everywhere.” That the dreadful something warned against continues to exist anywhere should fill us with an inextinguishable yearning to do something. Our impotence to action against the brutality of mass slaughter shames us. We have the historical record to ransack for precedent and corollaries—letters, documents, testaments, books—written words that would even “preserve their validity in the eyes of a man threatened with instant death.” The truths gleanable from the record of totalitarian barbarianism cited in them may be common knowledge; they are by no means commonly acknowledged. They appear in print upon many a page; they have not yet—still not yet—sufficiently penetrated human consciousness. Herein lies the supreme lesson for intellectuals, those who have the projective power to grasp what is not yet evident to the general human consciousness: it is possible to bring down totalitarian regimes either by violence or by a gradual transformation of human consciousness; it is not possible to bring them down “if we ignore them, make excuses for them, yield to them or accept their way of playing the game” in order to avoid violence. The history of the gentle revolutions of Poland, Hungary, and Czechoslovakia suggests that those revolutions would not have happened at all, and certainly not bloodlessly, without the moral engagement and political activism of intellectuals in those besieged cultures. Hundreds of thousands of students, workers, and peasants joined in the final efforts to defeat the totalitarian regimes that collapsed in 1989. Still, it was the intellectuals, during decades when they repeatedly risked careers, freedom, and their very lives, often in dangerous solitary challenges to power, who formed the unifying consensus, developed the liberating philosophy, wrote the rallying cries, framed the politics, mobilized the will and energies of disparate groups, and literally took to the streets to lead nonviolent protests that became revolutions. The most profound insights into this process that gradually penetrated social consciousness sufficiently to make revolution possible can be read in the role Vaclav Havel played before and during Czechoslovakia’s Velvet Revolution. As George Steiner reflects, while “the mystery of creative and analytic genius . . . is given to the very few,” others can be “woken to its presence and exposed to its demands.” Havel possesses that rare creative and analytic genius. We see it in the spaciousness of his moral vision for the future, distilled from the crucible of personal suffering and observation; in his poet’s ability to translate both experience and vision into language that comes as close as possible to truth and survives translation across cultures; in the compelling force of his personal heroism. Characteristically, Havel raises local experience to universal relevance. “If today’s planetary civilization has any hope of survival,” he begins, “that hope lies chiefly in what we understand as the human spirit.” If we don’t wish to destroy ourselves in national, religious or political discord; if we don’t wish to find our world with twice its current population, half of it dying of hunger; if we don’t wish to kill ourselves with ballistic missiles armed with atomic warheads or eliminate ourselves with bacteria specially cultivated for the purpose; if we don’t wish to see some people go desperately hungry while others throw tons of wheat into the ocean; if we don’t wish to suffocate in the global greenhouse we are heating up for ourselves or to be burned by radiation leaking through holes we have made in the ozone; if we don’t wish to exhaust the nonrenewable, mineral resources of this planet, without which we cannot survive; if, in short, we don’t wish any of this to happen, then we must—as humanity, as people, as conscious beings with spirit, mind and a sense of responsibility—somehow come to our senses. N25 Somehow we must come together in “a kind of general mobilization of human consciousness, of the human mind and spirit, human responsibility, human reason.”
Contention Two is Solvency
The United States is uniquely positioned to do disease surveillance due to technical expertise.
(Population and Development Review, March 96, “The National Science and Technology Council on Emerging and Re-emerging Infectious Diseases” Vol. 22, No. 1., JSTOR) [Ram]
A global system for infectious disease surveillance and response will help protect the health of American citizens and people throughout the world. In addition, the improvement of international health is a valuable component of the U.S. effort to promote worldwide political stability through sustainable economic development. Healthy people are more productive and better able to contribute to their countries' welfare. Also, a global disease surveillance and response network will enable the United States to respond quickly and effectively in the event of an attack involving biological or chemical warfare, as the experience gained in controlling naturally occurring microbes will enhance our ability to cope with a biological warfare agent, should the need arise. The release of nerve gas in the Tokyo subway system in March 1995 has underscored our need to be well prepared to counteract deliberate attempts to undermine human health. Thus, the effort to build a global surveillance and response system is in accord with the national security and foreign policy goals of the United States. Moreover, leadership in global infectious disease surveillance and control is a natural role for the United States. American business leaders and scientists are in the forefront of the computer communications and biomedical research communities (both public and private sector) that provide the technical and scientific underpinning for disease surveillance. Furthermore, American scientists and public health professionals have been among the most important contributors to the international efforts to eradicate smallpox and polio.
US action is critical to spur international cooperation which is necessary to solve case.
(Population and Development Review, March 96, “The National Science and Technology Council on Emerging and Re-emerging Infectious Diseases” Vol. 22, No. 1., JSTOR) [Ram]
The challenge ahead outstrips the means available to any one country or to international organizations. The U.S. Government must not only improve its capacity to meet the growing threat of emerging infectious diseases, but also work in concert with other nations and international bodies. Although international efforts must be coordinated to prevent global pandemics, disease surveillance must be the responsibility of each sovereign nation. However, individual governments may not easily share national disease surveillance information, fearing losses in trade, tourism and national prestige. Nevertheless, because U.S. experts are often consulted on problems of infectious disease recognition and control, the U.S. Government is usually informed about major disease outbreaks in other countries, although not always in an official or timely fashion. To ensure that we continue to be notified when an unusual outbreak occurs, we must encourage and support other countries' efforts in national disease surveillance and respond when asked for assistance. We must strive to develop a sense of shared responsibility and mutual confidence in the international effort to combat infectious diseases. There is much room for optimism. If the United States takes the lead, we can expect that other nations will contribute resources to a global surveillance system. Both Canada and the European Union have recently decided- in spite of tight budgets-to provide substantial funds ($7 and $10 million per year, respectively) to strengthen infectious disease surveillance and control. It is also absolutely critical that developing nations be engaged in an international effort that is in their own interests. In May 1995, WHO passed a resolution urging member states "to strengthen national and local programmes of surveillance for infectious diseases, ensuring that outbreaks of new, emerging, and reemerging infectious diseases are identified." Soon after the resolution was drafted, WHO issued a report urging the strengthening of global disease surveillance and control, and encouraging greater use of WHO Collaborating Centers in this endeavor.
Lack of US leadership would destroy all other multilateral efforts at international cooperation.
David P. Fidler, B.A., 1986, University of Kansas; J.D., 1991, Harvard Law School; M. Phil. International Relations, 1988, University of Oxford; B.C.L., 1991, University of Oxford. Associate, Sullivan & Cromwell, London, 1991-93. Associate, Stinson, Mag & Fizzell, Kansas City, 1993-95. Lecturer, University of Oxford, 1990-93; Professor, International Law, Indiana; World authority on bioterrorism, infectious diseases, and foreign investment; Consultant, WHO and US Centers for Disease Control and Prevention, Global Public Health; Advisor, US Department of Defense, Bioterrorism, and to the Federation of American Scientists Working Group on Biological Weapons, Spring 2002, “Bioterrorism, Public Health, And International Law,” Chicago Journal of International Law 7-25 , 23-25, http://academic.udayton.edu/health/syllabi/Bioterrorism/2PublicHealth/PHealth01.htmbchang
B. Global Public Health and Bioterrorism: Whither the United States? The global public health debacle of HIV/AIDS and the general global crisis in infectious diseases led experts in the late 1990s and early 2000s to argue that the United States must become more engaged in global public health. Sometimes these arguments connected public health with national security by claiming that both naturally-occurring infectious diseases and bioterrorism constituted a national security threat to the United States. By and large, the arguments that infectious diseases represented a national security threat made little impact in Washington, DC. The only arguments that resonated in Washington related to bioterrorism and biological weapons proliferation, which represented the most traditional form of national security threats. In the wake of the anthrax attacks, the White House and Congress solidified prior spending patterns by preparing to spend billions of dollars for homeland defense against bioterrorism. This mounting national and homeland security effort will dominate US attitudes toward global public health for the foreseeable future. We may witness a shift in the United States from a weak global perspective on naturally occurring infectious diseases that largely affect other countries to a strong national concern about the malevolent use of pathogenic microbes against Americans. US engagement in global public health will, thus, not stray far from the objective of protecting the homeland from bioterrorism, as evidenced by US participation in the Ottawa Plan, even though millions of people in developing countries will continue to suffer and die annually from infectious diseases unrelated to bioterrorism. As the victim of bioterrorism, the United States understandably needs to focus on homeland defense and the public health contribution to that objective. As people experienced with the bioterrorism debate prior to the anthrax attacks understood, US vulnerability to bioterrorism is enormous. Federal and state governments have almost endless intelligence, law enforcement, and public health work to do to protect Americans from bioterrorism. The combination of the September 11th violence and the anthrax attacks leaves the US government with no choice but to focus energetically on a comprehensive homeland defense. The focus on homeland defense will filter through to US attitudes toward the role of international law in public health. The United States will attempt to use international law to fight bioterrorism rather than to grapple with the global crisis in naturally occurring infectious diseases. Making sure bioterrorism is criminalized globally will supercede the need to build a global infectious disease surveillance system. Given the fusion of public health and national security in the wake of bioterrorism, the United States will not hesitate to use its power, influence, and resources to make the fight against bioterrorism central to its outlook on the role of international cooperation and international law in global public health. Infectious disease problems in the developing world will be even less important to the United States in the post-anthrax world than they were previously. The lack of US leadership and engagement with global public health will handicap efforts by other states, international organizations, and non- governmental organizations to advance multilateral cooperation on global public health problems. Even if the 2001 anthrax attacks prove to be an isolated phenomenon, the experience of bioterrorism on US soil will distract US attention from traditional public health challenges around the world. The slow, frustrating, and incomplete progress made in raising US awareness about the global crisis in infectious diseases in the 1990s may now be another victim of bioterrorism in the United States.
Disease surveillance effectively contains disease through allowing for pattern recognition and basic precautionary procedure—local health workers alone lack necessary skills.
James Thuo Njugana, Master’s Degree in Biotechnology; Writer, Bonn International Center for Conversion, Biological and Chemical Weapons; Member, International Livestock Research Institute, worked on control of trypanosomosis and malaria; Writer, African Security Review [Peer Reviewed], 2005, Institute for Security Studies, African Security Review, Volume 14, Issue 1,
http://www.openj-gate.org/Articlelist.asp?Source=1&Journal_ID=103955bchang
Ministries of health (MoHs) across Africa are mandated to deal with all health issues -including budgetary allocations to deal with infectious disease outbreaks. They are -responsible for -containing disease outbreaks wherever they occur in a country. Hospitals and care-giving institutions have a core function owing to their being in a special position to recognise an emerging outbreak of a given disease.24 Early detection of a biological agent attack or a natural outbreak depends on epidemiological warning networks and the individual clinical/laboratory expertise of medical personnel, because diagnostic procedures are the same for disease that is caused deliberately and for infections that occur naturally.25 During a crisis or outbreak an MoH may involve the services of its internal agencies or refer the matter to international organisations such as World Health Organisation (WHO) or non-governmental organisations (NGOs) for relevant action and to obtain support. Outbreaks of rare diseases are unpredictable and local health personnel may fail to recognise the early signs at the onset of a major epidemic, mostly because of lack of relevant skills. When this happens, people with contagious infections are allowed to move freely, putting others at risk. Corpses may be released for burial without a public health caution. When field workers in remote locations suspect a rare infectious disease, the referral/reference centres in the cities may not always have the facilities and reagents for some required tests. Samples then have to be sent abroad for testing to positively identify the infecting agents. This takes time and makes the management of the disease outbreak even more challenging as medical personnel have to deal blindly with unknown agents until identification details come from abroad. Consultation between operators is complicated by distance. Epidemic situations are always of concern to the members of public as well as the health professionals. The ministry of health is usually under pressure to do its best, a task made more difficult by the lack of resources in many -developing countries. Payment for health services by the users in some countries26 is a further impediment, as many cannot afford these costs. It is therefore in the interest of society that certain services should not be charged for, as this provides an incentive for people to seek treatment.27 The other impediment to effective public health management is the complete lack of infrastructure in some areas in developing countries. Sick people often die before they reach -hospitals. Poor communication means that outreach by public health educators is difficult and requires additional resources. Radio broadcasts could be of great help, but this service is not -developed either. Use of early warning systems such as weather forecasts and satellite imaging to predict and contain outbreaks should be part of the health management strategy. Heavy rains have been noted to be of key importance in disease outbreaks.28 Many epidemics are associated with extended heavy rains and include both vector-borne and water-borne diseases. The relationship between heavy rains and disease outbreaks could help to identify incidents of deliberately caused disease. The outbreak of major diseases under ordinary climatic conditions should be regarded with suspicion and infecting organisms studied further.
Disease surveillance is critical to all other methodologies of containing disease—it’s necessary for any system dealing with health.
Mac W. Otten, Jr., MD, MPH, Medical Epidemiologist, African Regional Office (WHO) and Helen Perry, MA, Educational Design Specialist, Division of International Health (CDC), 6/01, World Health Organization Regional Office for Africa and the Centers for Disease Control and Prevention, “Technical Guidelines for Integrated Disease Surveillance and Response in the African Region,” Harare, Zimbabwe and Atlanta, Georgia, USA, http://www.cdc.gov/idsr/focus/surv_sys_strengthening/tech_guidelines-integrated-diseaseENG.pdf//bchang
Communicable diseases are the most common causes of death, disability and illness in the African region. While these diseases present a large threat to the well-being of African communities, there are well-known interventions that are available for controlling and preventing them. Surveillance data can guide health personnel in the decision making needed to implement the proper strategies for disease control and lead to activities for preventing future cases. Surveillance is a watchful, vigilant approach to information gathering that serves to improve or maintain the health of the population. A functional disease surveillance system is essential for defining problems and taking action. Using epidemiological methods in the service of surveillance equips district and local health teams to set priorities, plan interventions, mobilize and allocate resources and predict or provide early detection of outbreaks. Depending on the goal of the disease prevention programme, the surveillance activity objectives guides programme managers towards selecting data that would be the most useful to collect and use for making evidenced-based decisions for public health actions. A disease control program may want to know what progress is being made with its prevention activities. The program collects age and vaccination statues for cases of vaccine-preventable diseases. If the program’s goal is to prevent outbreaks, the surveillance unit can monitor the epidemiology of a particular disease so that the program can more accurately identify where the next cases might occur or the populations at highest risk. In addition, improving laboratory support for disease surveillance is essential for confirming causes of illness and early detection of outbreaks. Casebased investigation and laboratory confirmation provide the most precise 2 information about where action must be taken to achieve an elimination target. Monitoring populations at highest risk for a particular disease can help to predict future outbreaks and focus prevention activities in the areas where they are most needed.